Determinants of colorectal cancer screening use, attempts, and non-use
Determinants of colorectal cancer screening use, attempts, and non-use
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DOI：
10.1016/j.ypmed.2006.04.004
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发表时间：
2007-05-01
影响因子：
5.1
通讯作者：
Katz, Steven J.
中科院分区：
文献类型：
--
作者：
Janz, Nancy K.;Lakhani, Indu;Katz, Steven J.
背景相对较少的是知道用户的经验和偏好和那些谁尝试结直肠癌（CRC）筛查。本研究描述了影响CRC筛查决定的因素，包括使用者、筛查者、筛查者（尝试并完成至少一项筛查程序的个人）和非使用者;确定了干扰测试完成的因素;并描述了筛查偏好的相关性。2003年秋季，对密歇根大学卫生系统诊所（安阿伯，密歇根）的患者进行了主要分层随机抽样，并对FOBT患者进行了过抽样，完成了邮寄问卷。描述性和多变量方法评估了影响筛查使用和偏好的因素。在决定是否进行CRC筛查时，无论筛查状态如何，“结果的准确性”都是最重要的。不同筛查状态的患者心理决策因素的重要性差异有统计学意义（P< 0.05）。在影响检查完成的因素中，38.5%的尝试FOBT的人报告他们“忘记”，而29.8%的尝试结肠镜检查的人报告他们“害怕疼痛”。大约56.3%的人倾向于CRC检查：认为“不适”重要的受访者首选FOBT（OR：0.39，95%CI：0.17，0.87）;那些既往结肠镜检查的人首选侵入性检查（OR：6.50，95%CI：2.90，14.50）。为了提高对CRC筛查建议的依从性，医生应该根据患者的既往经历和测试特定问题进行讨论，并了解患者对筛查的偏好。(C)2006年由Elsevier Inc.出版
Background. Relatively little is known about the experiences and preferences of users and those who attempt colorectal cancer (CRC) screening. This study describes factors influencing CRC screening decisions among users, attempters, attempter users (individuals who both attempted and completed at least one screening procedure), and non-users; identifies factors interfering with test completion; and describes correlates of screening preferences.Methods. A primarily stratified random sample of patients from the University of Michigan Health System clinics, Ann Arbor, Michigan, with oversampling of FOBT attempters, completed a mailed questionnaire in fall, 2003. Descriptive and multivariate approaches evaluated factors influencing screening use and preferences.Results. "Accuracy of results" was reported most often as important when deciding about CRC screening regardless of screening status. The importance of psychological decisional factors differed significantly by screening status (P< 0.05). Among factors interfering with test completion, 38.5% attempting FOBT reported they "forgot" whereas 29.8% attempting colonoscopy were "afraid of pain." Approximately 56.3% indicated a preference fora CRC test: respondents who considered "discomfort" important preferred FOBT (OR: 0.39, 95% CI: 0.17, 0.87); those with aprior colonoscopy preferred an invasive test (OR: 6.50, 95% CI: 2.90, 14.50).Conclusions. To improve adherence to CRC screening recommendations, physicians should tailor discussions to patients' prior experiences and test-specific concerns and elicit preferences for screening. (C) 2006 Published by Elsevier Inc.