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慢性病和带有种族偏见的医疗保健经历影响不同种族/族裔群体的乳腺癌和结直肠癌筛查。

Chronic Conditions and Racially Biased Healthcare Experiences Impact Breast Cancer and Colorectal Cancer Screening Across Racial/Ethnic Groups.

作者信息

Pollard Elinita, Vernon Marlo, Jones Samantha, Idun Ara, Guha Avirup, Islam K M Monirul, Tsai Meng-Han

机构信息

Georgia Prevention Institute, Augusta University, 1120 15 Street HS-1705, Augusta, GA, 30912, USA.

Center for Health Equity Transformation, University of Kentucky, Lexington, KY, USA.

出版信息

J Racial Ethn Health Disparities. 2025 May 5. doi: 10.1007/s40615-025-02460-3.

Abstract

INTRODUCTION

Mammogram uptake and colorectal cancer (CRC) screening are influenced by racially biased healthcare experiences and presence of chronic conditions; moreover, there is racially/ethnically disparate uptake of each. The current study aimed to expand on extant literature by examining the association between racially biased healthcare experiences and chronic conditions across three racial/ethnic groups.

METHODS

We conducted weighted multivariable logistic regressions to examine the interaction between chronic conditions (none, cancer, other chronic conditions) and racially biased healthcare experiences (none, better, worse, other) on mammogram and CRC screening adherence across three racial/ethnic groups (non-Hispanic White [NHW], non-Hispanic Black [NHB], Hispanic/non-Hispanic Other [NHO]) using 2022 Behavioral Risk Factor Surveillance System data.

RESULTS

Among 42,053 and 86,033 eligible respondents for mammogram and CRC screening, most respondents had an up-to-date mammogram (77.4%) or CRC test (67.0%). In adjusted analysis, Hispanic/NHO respondents with conditions other than cancer and felt they were treated worse than other races while seeking healthcare had a decreased odds of having an up-to-date mammogram (OR 0.21, 95% CI 0.09-0.46). NHW respondents with cancer who felt they were treated better than other races while seeking healthcare had increased odds of having an up-to-date mammogram (OR 1.70, 95% CI 1.11-2.60). All significant associations (i.e., p < 0.05) between chronic conditions and CRC screening were positive, regardless of treatment while seeking healthcare across racial/ethnic groups.

CONCLUSIONS

Culturally sensitive interventions aimed at improving patient-centered communication may improve mammogram and CRC screening adherence, particularly for racially/ethnically minoritized groups.

摘要

引言

乳房X光检查的接受情况和结直肠癌(CRC)筛查受到种族偏见的医疗经历和慢性病的影响;此外,每种检查的接受情况在种族/族裔方面存在差异。当前的研究旨在通过考察三个种族/族裔群体中种族偏见的医疗经历与慢性病之间的关联,对现有文献进行拓展。

方法

我们使用2022年行为风险因素监测系统的数据,进行加权多变量逻辑回归,以考察慢性病(无、癌症、其他慢性病)与种族偏见的医疗经历(无、较好、较差、其他)在三个种族/族裔群体(非西班牙裔白人[NHW]、非西班牙裔黑人[NHB]、西班牙裔/非西班牙裔其他[NHO])的乳房X光检查和CRC筛查依从性方面的相互作用。

结果

在42,053名和86,033名符合乳房X光检查和CRC筛查条件的受访者中,大多数受访者进行了最新的乳房X光检查(77.4%)或CRC检测(67.0%)。在调整分析中,患有癌症以外疾病且在寻求医疗服务时感觉自己比其他种族受到更差对待的西班牙裔/NHO受访者进行最新乳房X光检查的几率降低(比值比[OR]为0.21,95%置信区间[CI]为0.09 - 0.46)。患有癌症且在寻求医疗服务时感觉自己比其他种族受到更好对待的NHW受访者进行最新乳房X光检查的几率增加(OR为1.70,95% CI为1.11 - 2.60)。慢性病与CRC筛查之间的所有显著关联(即p < 0.05)均为正向,无论不同种族/族裔群体在寻求医疗服务时的待遇如何。

结论

旨在改善以患者为中心的沟通的文化敏感干预措施可能会提高乳房X光检查和CRC筛查的依从性,特别是对于种族/族裔少数群体。

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