Cancer screening among Latino subgroups in the United States
Cancer screening among Latino subgroups in the United States
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DOI：
10.1016/j.ypmed.2004.09.031
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发表时间：
2005-05-01
影响因子：
5.1
通讯作者：
Heck, JE
中科院分区：
文献类型：
--
作者：
Gorin, SS;Heck, JE
背景。本研究依据健康信念模式和医疗保健利用行为模式，旨在调查拉丁裔亚群体当前对癌症筛查的依从性。
方法。利用2000年美国全国健康访谈调查的数据，对5377名拉丁裔进行了调查，了解女性的巴氏涂片检查、乳房X线摄影、乳房自我检查和临床乳房检查情况，男性的前列腺特异性抗原检测情况，以及男女的粪便潜血试验、乙状结肠镜检查、结肠镜检查和直肠镜检查情况。采用抽样权重，运用多元逻辑回归模型评估筛查的使用情况。
结果。多米尼加女性接受乳房X线摄影的可能性是其他拉丁裔的2.4倍。此外，年龄在50 - 69岁、受教育年限较长、有癌症个人病史、非当前吸烟者、有医疗保险、在过去12个月内看过初级保健医生且至少进行过一次其他筛查测试的拉丁裔女性，乳房X线摄影的使用率更高。较年轻、已婚、文化适应程度较高、看过初级保健医生、有医疗保险以及使用过其他癌症筛查测试可预测巴氏涂片检查的接受情况。如果拉丁裔女性较年轻、拥有学士学位、有癌症个人病史、文化适应程度较高、在过去12个月内看过初级保健医生且使用过其他癌症筛查测试，则更有可能进行临床乳房检查。波多黎各人、中美洲或南美洲人进行结直肠癌筛查的可能性是其他群体的一半。年龄在50 - 69岁、男性、已婚、有就医史以及使用过其他筛查测试可预测粪便潜血试验的使用情况。年龄较大、受教育程度较高、男性、前一年有就医史、使用过其他筛查测试以及健康状况较好会影响结直肠癌筛查内镜检查的接受情况。古巴男性进行前列腺特异性抗原检测的利用率是其他群体的五倍。此外，拉丁裔中前列腺特异性抗原的使用情况可由年龄较大、在过去12个月内看过初级保健医生以及使用过其他筛查测试来预测。
结论。癌症筛查项目必须考虑拉丁裔在年龄、性别、教育水平、婚姻状况、癌症病史、风险行为、保险、健康状况和医疗服务利用方面的差异。（c）2004癌症预防研究所和爱思唯尔公司。版权所有。
Background. Relying upon the Health Belief Model and a behavioral model of health care utilization, the purpose of this study was to examine current adherence to cancer screening among Latino subgroups.Methods. Using data from the 2000 National Health Interview Survey, 5377 Latinos were surveyed for their use of Pap smear, mammogram, breast self-examination and the clinical breast exam among women, prostate specific antigen test among men, and the fecal occult blood test, sigmoidoscopy, colonoscopy, and proctoscopy among both men and women. Using sampling weights, multivariate logistic regression models were used to assess screening use.Results. Dominican women had 2.4 times greater likelihood of having had mammography than other Latinos. In addition, Latinas aged 50-69, who had more years of education, a personal history of cancer, who were not current smokers, had health insurance, had visited a primary care provider over the past 12 months, and had at least one other screening test had greater use of mammography. Younger age, marriage, greater acculturation, visits to a primary care provider, health insurance, and the use of other cancer screening tests predicted the uptake of the Pap smear. Latinas were more likely to use a CBE if they were younger, had a Bachelor's degree, a personal history of cancer, were more acculturated, had visits to a primary care provider over the past 12 months, and used other cancer screening tests. Puerto Ricans, Central or South Americans had half the likelihood of having colorectal cancer screening than other groups. Ages between 50 and 69, male sex, marriage, history of visiting a health care provider, and use of other screening tests predicted use of the FOBT Older age, greater education, male sex, history of visiting a health care provider in the previous year, use of other screening tests, and better health status influenced the uptake of endoscopy for colorectal cancer screening. Cuban males had fivefold greater utilization of PSA testing. Additionally, PSA use among Latinos was predicted by older age, history of visiting a primary care provider in the past 12 months, and use of other screening tests.Conclusions. Cancer screening programs must take into account differences among Latinos in age, gender, educational levels, marital status, cancer history, risk behaviors, insurance, health status and health services utilization. (c) 2004 The Institute For Cancer Prevention and Elsevier Inc. All lights reserved.