Patterns of colorectal cancer screening uptake in newly eligible men and women.
Patterns of colorectal cancer screening uptake in newly eligible men and women.
复制标题
DOI：
10.1158/1055-9965.epi-13-1360
复制
发表时间：
2014-07
期刊：
影响因子：
--
通讯作者：
Rutter CM
中科院分区：
文献类型：
--
作者：
Wernli KJ;Hubbard RA;Johnson E;Chubak J;Kamineni A;Green BB;Rutter CM
我们描述了美国参保人群在 50 岁时新符合筛查资格时结直肠癌筛查的模式，并通过筛查情况评估时间趋势和患者特征。我们确定了 81,223 名 1996 年至 2010 年间年满 50 岁的 Group Health 成员的队列。我们确定在五年内接受了结直肠癌筛查。使用累积发生率曲线和 Cox 比例风险模型估计与筛查相关的患者特征，根据队列进入年份估计筛查时间。基于粪便的筛查测试是最常见的，占首次筛查测试的 72%。通过结肠镜检查开始结直肠癌筛查的个人比例从 1996-98 年的 8% 增加到 2008-10 年的 33%。与结直肠癌筛查增加相关的患者因素包括：最近年满 50 岁（2008-10）（p 趋势<0.0001）或亚洲人种（HR=1.14，95% CI 1.10-1.19）。与筛查减少相关的患者因素包括：女性（HR=0.70，95% CI 0.68–0.72）、美洲原住民（HR=0.68，95% CI 0.60–0.78）或太平洋岛民种族（HR=0.82，95% CI 0.72–0.95）以及患有糖尿病（HR=0.78，95% CI 0.72–0.95） 0.75–0.82）和更高的体重指数（p-趋势<0.0001）。在新符合资格的人群中与开始结直肠癌筛查相关的患者特征与与所有符合年龄资格的成年人的总体筛查参与相关的特征相似。我们的结果确定了外展计划的目标患者群体。从符合年龄的队列开始，接受结直肠癌筛查的差异就很明显，确定了未来筛查干预措施的关键群体。
We describe patterns of colorectal cancer screening uptake in a U.S. insured population as individuals become newly-eligible for screening at age 50 and assess temporal trends and patient characteristics with screening uptake. We identified a cohort of 81,223 men and women who were members of Group Health and turned 50 years old from 1996 – 2010. We ascertained receipt of colorectal cancer screening within five years. Time to screening was estimated by year of cohort entry using cumulative incidence curves and Cox proportional hazards models estimated patient characteristics associated with screening uptake. Stool-based screening tests were the most common, 72% of first screening tests. The proportion of individuals initiating colorectal cancer screening via colonoscopy increased from 8% in 1996–98 to 33% in 2008–10. Patient factors associated with increased colorectal cancer screening were: turning 50 more recently (2008–10) (p-trend<0.0001) or Asian race (HR=1.14, 95% CI 1.10–1.19). Patient factors associated with decreased screening were: being a woman (HR=0.70, 95% CI 0.68–0.72), Native American (HR=0.68, 95% CI 0.60–0.78) or Pacific Islander race (HR=0.82, 95% CI 0.72–0.95), and having prevalent diabetes (HR=0.78, 95% CI 0.75–0.82) and higher body mass index (p-trend<0.0001). Patient characteristics associated with initiation of colorectal cancer screening in a newly-eligible population are similar to characteristics associated with overall screening participation in all age-eligible adults. Our results identify patient populations to target in outreach programs. Disparities in receipt of colorectal cancer screening are evident from onset of an age-eligible cohort, identifying key groups for future interventions for screening.