Behavioral associations between prostate and colon cancer screening
Behavioral associations between prostate and colon cancer screening
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DOI：
10.1016/j.jamcollsurg.2004.10.015
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发表时间：
2005-02-01
影响因子：
5.2
通讯作者：
Bernstein, SJ
中科院分区：
文献类型：
--
作者：
Carlos, RC;Underwood, W;Bernstein, SJ
背景技术背景：尽管对常规前列腺特异性抗原（PSA）筛查在降低前列腺癌特异性死亡率方面的效用存在争议，但它在美国得到了广泛使用。尽管结直肠癌（CRC）筛查降低了CRC死亡率，并且似乎具有成本效益，但CRC筛查依从性并不理想。为了更好地了解筛查行为在男性中，行为风险因素监测调查被用来确定潜在的关系，这将使干预措施，以提高CRC screen.Study设计：我们包括在我们的分析22,304名男子，50岁及以上，谁参加了2002年的行为风险因素监测调查。进行卡方和多变量分析以确定坚持CRC筛查的独立相关性。独立变量评估年龄，种族，教育水平，就业状况，收入，健康保险，私人医生的存在，自我报告的一般健康状况，目前的吸烟状况，并接受PSA test.RESULTS：男性更坚持PSA筛查比CRC筛查（50.4%比47.6%; P < 0.002）。在多变量分析中，PSA筛查依从性（校正比值比[OR] 3.24，p < 0.001）对CRC筛查依从性产生最大的独立影响。其他与CRC筛查依从性呈正相关的因素是有健康保险（调整后OR 1.39，p < 0.01）和私人医生（调整后OR 2.01，p < 0.01）。年龄与CRC筛查呈倒U相关。未能坚持CRC筛查与自我报告的健康状况良好（调整OR 0.87，p < 0.01）和目前吸烟（调整OR 0.65，p < 0.01）相关。即使在男性谁是符合PSA检测，CRC筛查仍然是次优（65%）。结论：更多的男性接受PSA检测比CRC筛查。接受PSA检测的男性更有可能坚持CRC筛查。总的来说，PSA测试可能代表了一个“可教的时刻”，为行为相关的干预，旨在降低结肠癌的风险。针对已经接受一种形式的癌症筛查的男性可能会增加CRC筛查的依从性。(C)2005年，美国外科医生学会。
BACKGROUND: Despite the controversy over the utility of routine prostate-specific antigen (PSA) screening in reducing prostate cancer-specific mortality, it has gained widespread use throughout the United States. Although colorectal cancer (CRC) screening reduces CRC mortality and appears to be cost effective, CRC screening adherence is suboptimal. To better understand screening behaviors among men, the Behavioral Risk Factors Surveillance Survey was used to identify potential relationships that would allow interventions to enhance CRC screening.STUDY DESIGN: We included in our analysis 22,304 men, 50 years and older, who participated in the 2002 Behavioral Risk Factors Surveillance Survey. Chi-square and multivariate analyses were performed to determine the independent correlates of adherence to CRC screening. Independent variables evaluated were age, race, educational level, employment status, income, health insurance, the presence of a personal physician, self-reported general health, current smoking status, and receiving a PSA test.RESULTS: Men were more adherent with PSA screening than CRC screening (50.4% versus 47.6%; p < 0.002). In multivariate analysis, adherence to PSA screening (adjusted odds ratio [OR] 3.24, p < 0.001) exerted the largest independent effect on CRC screening adherence. Other positive correlates of adherence to CRC screening were having health insurance (adjusted OR 1.39, p < 0.01) and a personal physician (adjusted OR 2.01, p < 0.01). Age predicted CRC screening with an inverse-U correlation. Failure to adhere to CRC screening was associated with self-reported good health (adjusted OR 0.87, p < 0.01) and being a current smoker (adjusted OR 0.65, p < 0.01). Even in men who were compliant with PSA testing, CRC screening remained suboptimal (65%).CONCLUSIONS: More men received PSA testing than CRC screening. Men who received PSA testing were more likely to adhere to CRC screening. Taken together, PSA testing may represent a "teachable moment" for a behavior-related intervention aimed at reducing the risk of colon cancer. Targeting men who already accept one form of cancer screening can potentially increase CRC screening adherence. (C) 2005 by the American College of Surgeons.