Racial/Ethnic Disparities in Colorectal Cancer Screening Across Healthcare Systems
Racial/Ethnic Disparities in Colorectal Cancer Screening Across Healthcare Systems
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DOI：
10.1016/j.amepre.2016.02.025
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发表时间：
2016-10-01
影响因子：
5.5
通讯作者：
Doubeni, Chyke A.
中科院分区：
文献类型：
--
作者：
Burnett-Hartman, Andrea N.;Mehta, Shivan J.;Doubeni, Chyke A.
前言：结直肠癌（CRC）筛查和诊断检测中的种族/民族差异对CRC预防计划提出了挑战。因此，重要的是要了解医疗系统之间的CRC筛查方法的差异是如何与种族/ethnic difficulties.Methods相关的：这是一项回顾性队列研究，患者年龄在50-75岁，他们是2010年至2012年基于人群的研究通过个性化方案优化筛查队列的成员。关于人种/种族、CRC筛查和诊断测试的数据来自医疗记录。数据收集于2014年进行，分析于2015年进行。使用逻辑回归模型计算不同人种/种族组之间CRC筛查完成情况的AOR和95% CI。按医疗系统进行分层分析，以评估systems.Results之间的差异：有1，746，714名参与者在四个医疗系统。与非西班牙裔白人（白人）相比，非西班牙裔黑人（黑人）在具有高筛查率的医疗保健系统中完成CRC筛查的几率较低（AOR = 0.86，95% CI = 0.84，0.88），但在具有较低筛查率的系统中，黑人和白人之间相似（AOR = 1.01，95% CI=0.93，1.09）。与白人相比，美洲印第安人/阿拉斯加原住民在所有医疗保健系统中完成CRC筛查的几率较低（AOR=0.76，95% CI=0.72，0.81）。西班牙裔有类似的几率CRC筛查（AOR=0.99，95% CI=0.98，1.00）和亚洲/太平洋岛民的CRC筛查几率更高（AOR=1.16，95% CI=1.15，1.18）与白人相比。CRC筛查中的种族/民族差异在医疗保健系统中各不相同，特别是黑人，并且在具有强化CRC筛选方法的系统中可能更明显。(C)2016年美国预防医学杂志。爱思唯尔公司出版All rights reserved.
Introduction: Racial/ethnic disparities in colorectal cancer (CRC) screening and diagnostic testing present challenges to CRC prevention programs. Thus, it is important to understand how differences in CRC screening approaches between healthcare systems are associated with racial/ethnic disparities.Methods: This was a retrospective cohort study of patients aged 50-75 years who were members of the Population-based Research Optimizing Screening Through Personalized Regimens cohort from 2010 to 2012. Data on race/ethnicity, CRC screening, and diagnostic testing came from medical records. Data collection occurred in 2014 and analysis in 2015. Logistic regression models were used to calculate AORs and 95% CIs comparing completion of CRC screening between racial/ethnic groups. Analyses were stratified by healthcare system to assess differences between systems.Results: There were 1,746,714 participants across four healthcare systems. Compared with non-Hispanic whites (whites), odds of completing CRC screening were lower for non-Hispanic blacks (blacks) in healthcare systems with high screening rates (AOR = 0.86, 95% CI = 0.84, 0.88) but similar between blacks and whites in systems with lower screening rates (AOR = 1.01, 95% CI=0.93, 1.09). Compared with whites, American Indian/Alaskan Natives had lower odds of completing CRC screening across all healthcare systems (AOR=0.76, 95% CI=0.72, 0.81). Hispanics had similar odds of CRC screening (AOR=0.99, 95% CI=0.98, 1.00) and Asian/Pacific Islanders had higher odds of CRC screening (AOR=1.16, 95% CI=1.15, 1.18) versus whites.Conclusions: Racial/ethnic differences in CRC screening vary across healthcare systems, particularly for blacks, and may be more pronounced in systems with intensive CRC screening approaches. (C) 2016 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.