Relation between literacy, race, and stage of presentation among low-income patients with prostate cancer
Relation between literacy, race, and stage of presentation among low-income patients with prostate cancer
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DOI：
10.1200/jco.1998.16.9.3101
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发表时间：
1998-09-01
影响因子：
45.3
通讯作者：
Sartor, O
中科院分区：
文献类型：
--
作者：
Bennett, CL;Ferreira, MR;Sartor, O
目的：晚期前列腺癌的诊断是一个主要的健康问题，特别是在低收入男性中。低收入黑人和白色男性早期发现前列腺癌的机会因经济、文化和社会因素而异。在这项研究中，我们评估了低收入的黑人和白色男性谁收到的照顾平等访问medical systems.Patients和方法：识字和前列腺癌诊断阶段的高发病率与识字能力差的协会在212个低收入的男性谁收到的医疗护理在什里夫波特，洛杉矶和芝加哥，IL。患者的读写能力通过成人医学读写能力快速评估（REALM）进行评估，这是一种专门为医疗环境设计的个人阅读筛选测试。Logistic回归模型用于评估患者年龄、种族、文化程度和城市等因素对转移性疾病的预测作用。（49.5%对35.9%; P <0.05），他们的识字水平明显更可能低于六年级（52.3%对8.7%; P <0.001）。然而，调整后的差异，识字，年龄和城市，种族是不是一个显着的预测晚期prostate cancer.Conclusion：低识字率可能是一个被忽视的，但显着的障碍，早期前列腺癌的诊断之间的法律收入白色和黑人男性。文化敏感，低识字教育材料的发展可能会提高患者对前列腺癌的认识，提高早期癌症的诊断频率。J Clin Oncol 16：3101-3104. (C)1998年，美国临床肿瘤学会。
Purpose: Diagnosis of advanced prostate cancer is a major health problem, especially among low-income men. Opportunities vary for early detection of prostate cancer for low-income black and white men because of financial, cultural, and social factors. In this study we evaluated the association of poor literacy skills with higher rates of presentation of advanced stages of prostate cancer among low-income black and white men who received care in equal-access medical systems.Patients and Methods: Literacy and stage at diagnosis of prostate cancer were evaluated in 212 low-income men who received medical care in Shreveport, LA, and Chicago, IL. The patients' literacy was assessed with the Rapid Estimate of Adult Literacy in Medicine (REALM), an individually administered reading screening test designed specifically for use in the medical setting. Logistic regression models were used to evaluate predictors of metastatic disease at presentation as a function of patient age, race, literacy, and city.Results: Whereas black men were almost twice as likely to present with stage D prostate cancer (49.5% v 35.9%; P < .05), they were significantly more likely to have literacy levels less than sixth grade (52.3% v 8.7%; P < .001). However, after adjustment for differences in literacy, age, and city, race was not a significant predictor of advanced-stage prostate cancer.Conclusion: Low literacy may be an overlooked but significant barrier to the diagnosis of early stage prostate cancer among law-income white and black men. The development of culturally sensitive, low-literacy educational materials may improve patient awareness of prostate cancer and improve the frequency of diagnosis of early-stage cancer. J Clin Oncol 16:3101-3104. (C) 1998 by American Society of Clinical Oncology.