Barriers to colorectal cancer screening: A comparison of reports from primary care physicians and average-risk adults
Barriers to colorectal cancer screening: A comparison of reports from primary care physicians and average-risk adults
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DOI：
10.1097/01.mlr.0000173599.67470.ba
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发表时间：
2005-09-01
期刊：
影响因子：
3
通讯作者：
Brown, ML
中科院分区：
文献类型：
--
作者：
Klabunde, CN;Vernon, SW;Brown, ML
背景：结直肠癌 (CRC) 筛查的障碍尚不清楚。目标：我们试图比较初级保健医生 (PCP) 和平均风险成年人报告的 CRC 筛查障碍，并检查平均风险成年人的特征，他们认为缺乏提供者推荐是 CRC 筛查的主要障碍。研究设计：这是一项比较研究，使用 1999-2000 年结直肠癌筛查实践调查和 2000 年全国健康访谈的数据调查 (NHIS)。 对象：我们从 SCCSP 中招募了具有全国代表性的 PCP 样本 (n = 1235)，从 NHIS 中招募了平均风险成人样本 (n = 6497)。 措施：我们测量了 PCP 和目前未进行筛查的平均风险成人发现的 CRC 筛查障碍。 结果：PCP 和平均风险成人均认为缺乏患者意识和医生建议是获得 CRC 筛查的主要障碍。 PCP 还经常提到患者对检测和检测费用感到尴尬/焦虑/缺乏保险范围，但很少有成年人认为这些是主要障碍。在没有进行过检测的成年人中，与没有就诊或没有健康保险的成年人相比，那些在过去一年里看过医生或有健康保险的成年人更有可能报告缺乏医生推荐，这是他们未能及时了解最新情况的主要原因。只有 10% 未进行检测且在过去一年曾看过医生的成年人报告收到了筛查建议。结论：需要继续努力向公众宣传 CRC 以及筛查在预防这种疾病中的重要作用。还需要基于实践的策略来系统地促使医疗保健提供者与符合条件的患者讨论 CRC 筛查。
Background: Barriers to colorectal cancer (CRC) screening are not well understood.Objectives: We sought to compare barriers to CRC screening reported by primary care physicians (PCPs) and by average-risk adults, and to examine characteristics of average-risk adults who identified lack of provider recommendation as a major barrier to CRC screening.Research Design: This was a comparative study using data from the 1999-2000 Survey of Colorectal Cancer Screening Practices and the 2000 National Health Interview Survey (NHIS).Subjects: We recruited nationally representative samples of PCPs (n = 1235) from the SCCSP and average-risk adults (n = 6497) from the NHIS.Measures: We measured barriers to CRC screening identified by PCPs and average-risk adults who were not current with screening.Results: Both PCPs and average-risk adults identified lack of patient awareness and physician recommendation as key barriers to obtaining CRC screening. PCPs also frequently cited patient embarrassment/ anxiety about testing and test cost/lack of insurance coverage, but few adults identified these as major barriers. Of adults not current with testing, those who had visited a doctor in the past year or had health insurance were more likely to report lack of physician recommendation as the main reason they were not up-to-date compared with their counterparts with no doctor visit or health insurance. Only 10% of adults not current with testing and who had a doctor visit in the past year reported receiving a screening recommendation.Conclusions: A need exists for continued efforts to educate the public about CRC and the important role of screening in preventing this disease. Practice-based strategies to systematically prompt health care providers to discuss CRC screening with eligible patients also are required.