Disparities in the Participation Rate of Colorectal Cancer Screening by Fecal Occult Blood Test among People with Disabilities: A National Database Study in South Korea
Disparities in the Participation Rate of Colorectal Cancer Screening by Fecal Occult Blood Test among People with Disabilities: A National Database Study in South Korea
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DOI：
10.4143/crt.2018.660
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发表时间：
2020-01-01
影响因子：
4.6
通讯作者：
Park, Jong Hyock
中科院分区：
文献类型：
--
作者：
Shin, Dong Wook;Chang, Dongkyung;Park, Jong Hyock
如果社会经济地位不同，筛查计划的实施可能会导致人群中健康差异的增加。在韩国，国家癌症筛查计划向所有50岁以上的人免费或以最低费用提供结肠直肠癌筛查。我们调查结直肠癌筛查的参与率及其趋势，在过去的10年中，在disability.Materials和MethodsWe国家残疾登记数据与国家癌症筛查计划的数据。年龄、性别标准化参与率按残疾类型和残疾严重程度进行分析，并采用多因素Logistic回归分析与结直肠癌筛查参与率相关的因素（变化，+17.7），但在严重残疾的人中，这一比例从12.7%上升到27.2%（变化，+14.5）。严重残疾者的结直肠癌筛查参与率明显低于无残疾者（调整后的比值比[aOR]，0.714; 95%置信区间，0.713至0.720）。自闭症患者（aOR，0.468），肾衰竭（aOR，0.498），脑损伤（aOR，0.581），造口（aOR，0.602），智力残疾（aOR，0.610）显示最低的参与率。结论尽管国家癌症筛查计划的可用性和整体增加其使用在韩国人口，在结肠直肠癌筛查参与方面发现了显著差异，特别是在患有严重残疾和/或几种特定类型残疾的人中。需要作出更大努力，查明这些特别弱势群体面临的障碍，并制定有针对性的干预措施，以减少不平等现象。
PurposeImplementation of screening program may lead to increased health disparity within the population if participation differs by socioeconomic status. In Korea, colorectal cancer screening is provided at no or minimal cost to all people over 50 by National Cancer Screening Program. We investigated colorectal cancer screening participation rate and its trend over the last 10 years in relation to disabilities.Materials and MethodsWe linked national disability registration data with National Cancer Screening Program data. Age, sex-standardized participation rates were analyzed by type and severity of disability for each year, and factors associated with colorectal cancer screening participation were examined by multivariate logistic regression.ResultsAge, sex-standardized participation rate in people without disability increased from 16.2 to 33.9% (change, +17.7), but it increased from 12.7% to 27.2% (change, +14.5) among people with severe disability. People with severe disabilities showed a markedly lower colorectal cancer screening participation rate than people without disability (adjusted odds ratio [aOR], 0.714; 95% confidence interval, 0.713 to 0.720). People with autism (aOR, 0.468), renal failure (aOR, 0.498), brain injury (aOR, 0.581), ostomy (aOR, 0.602), and intellectual disability (aOR, 0.610) showed the lowest participation rates.ConclusionDespite the availability of a National Cancer Screening Program and overall increase of its usage in the Korean population, a significant disparity was found in colorectal cancer screening participation, especially in people with severe disabilities and or several specific types of disabilities. Greater effort is needed to identify the barriers faced by these particularly vulnerable groups and develop targeted interventions to reduce inequality.