Disparities in Colorectal Cancer Screening by Time in the U.S. and Race/Ethnicity, 2010-2018.
Disparities in Colorectal Cancer Screening by Time in the U.S. and Race/Ethnicity, 2010-2018.
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2010-2018 年美国不同时间和种族/族裔的结直肠癌筛查差异。
DOI：
10.1016/j.amepre.2023.01.033
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发表时间：
2023
影响因子：
5.5
通讯作者：
Hiatt,RobertA
中科院分区：
文献类型：
--
作者：
Santiago-Rodríguez,EduardoJ;Shariff-Marco,Salma;Gomez,ScarlettL;Hiatt,RobertA
在美国生活的时间越长，健康状况越差，特别是可预防的疾病，在种族和民族多样化的外国出生的个人群体中。这项研究评估了在美国居住的时间与结直肠癌筛查依从性之间的关系，以及这种关系是否因种族和民族而异。方法采用2010 - 2018年全国健康访谈调查数据，调查对象为50 - 75岁的成年人。在美国的时间分为在美国出生、在国外出生≥15年和在国外出生<15年。结肠直肠癌筛查依从性是根据美国预防服务工作组指南定义的。采用泊松分布的广义线性模型计算校正患病率和95% ci。分析在2020 - 2022年进行，按种族和民族分层，考虑到复杂的抽样设计，并加权以代表美国人口。结果结直肠癌筛查依从性的总体患病率为63%，美国出生的为64%，国外出生≥15年的为55%，国外出生<15年的为35%。在所有个体的完全调整模型中，只有外国出生的<15岁的依从性低于美国出生的（外国出生的≥15岁：患病率=0.97[0.95,1.00]，外国出生的<15岁：患病率=0.79[0.71,0.88]）。结果因种族和民族而异（p-interaction=0.002）。在分层分析中，非西班牙裔白人个体（外国出生≥15岁：患病率=1.00[0.96,1.04]，外国出生<15岁：患病率=0.76[0.58,0.98]）和非西班牙裔黑人个体（外国出生≥15岁：患病率=0.94[0.86,1.02]，外国出生<15岁：患病率=0.61[0.44,0.85]）的结果与所有个体相似。在美国，西班牙裔/拉丁裔人群（外国出生≥15岁：患病率=0.98[0.92,1.04]，外国出生<15岁：患病率=0.86[0.74,1.01]）中未观察到不同时间的差异，但在亚裔美国人/太平洋岛民中存在差异（外国出生≥15岁：患病率=0.84[0.77,0.93]，外国出生<15岁：患病率=0.74[0.60,0.93]）。结论：在美国，结直肠癌筛查依从性与时间的关系因种族和民族而异。在外国出生的人群中，特别是在最近移民的人群中，需要根据文化和种族量身定制的干预措施来提高结直肠癌筛查的依从性。
IntroductionLonger time lived in the U.S. has been associated with worse health outcomes, especially preventable diseases, among racially and ethnically diverse groups of foreign-born individuals. This study evaluated the association between time lived in the U.S. and colorectal cancer screening adherence and whether this relationship differed by race and ethnicity.MethodsData from the National Health Interview Survey for 2010−2018 among adults aged 50−75 years were used. Time in the U.S. was categorized as U.S.-born, foreign-born ≥15 years, and foreign-born <15 years.Colorectal cancer screening adherencewas defined according to U.S. Preventive Services Task Force guidelines. Generalized linear models with Poisson distribution were used to calculate adjusted prevalence ratios and 95% CIs. Analyses were conducted in 2020−2022, were stratified by race and ethnicity, accounted for the complex sampling design, and were weighted to be representative of the U.S. population.ResultsPrevalence of colorectal cancer screening adherence was 63% overall, 64% for U.S.-born, 55% for foreign-born ≥15 years, and 35% for foreign-born <15 years. In fully adjusted models for all individuals, only foreign-born <15 years had lower adherence than U.S.-born (foreign-born ≥15 years: prevalence ratio=0.97 [0.95, 1.00], foreign-born <15 years: prevalence ratio=0.79 [0.71, 0.88]). Results differed by race and ethnicity (p-interaction=0.002). In stratified analyses, findings for non-Hispanic White individuals (foreign-born ≥15 years: prevalence ratio=1.00 [0.96, 1.04], foreign-born <15 years: prevalence ratio=0.76 [0.58, 0.98]) and non-Hispanic Black individuals (foreign-born ≥15 years: prevalence ratio=0.94 [0.86, 1.02], foreign-born <15 years: prevalence ratio=0.61 [0.44, 0.85]) were similar to all individuals. Disparities by time in the U.S. were not observed among Hispanic/Latino individuals (foreign-born ≥15 years: prevalence ratio=0.98 [0.92, 1.04], foreign-born <15 years: prevalence ratio=0.86 [0.74, 1.01]) but persisted among Asian American/Pacific Islander individuals (foreign-born ≥15 years: prevalence ratio=0.84 [0.77, 0.93], foreign-born <15 years: prevalence ratio=0.74 [0.60, 0.93]).ConclusionsThe relationship between colorectal cancer screening adherence and time in the U.S. varied by race and ethnicity. Culturally and ethnically tailored interventions are needed to improve colorectal cancer screening adherence among foreign-born people, especially among the most recently immigrated individuals.