Impact of comorbid conditions on participation in an organised colorectal cancer screening programme: a cross-sectional study.
Impact of comorbid conditions on participation in an organised colorectal cancer screening programme: a cross-sectional study.
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DOI：
10.1186/s12885-017-3516-x
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发表时间：
2017-08-07
期刊：
影响因子：
3.8
通讯作者：
Marzo-Castillejo M
中科院分区：
文献类型：
--
作者：
Guiriguet C;Pera G;Castells A;Toran P;Grau J;Rivero I;Buron A;Macià F;Vela-Vallespín C;Vilarrubí-Estrella M;Marzo-Castillejo M
关于合并症对结直肠癌筛查的影响存在争议，特别是在有组织的项目中。本研究的目的是评估合并症对参与巴塞罗那人群结直肠癌筛查计划（BCCSP）的影响。在参与BCCSP的10个初级保健中心进行了横断面研究。被邀请参加第一轮基于粪便免疫化学测试的BCCSP的年龄在50至69岁之间、结直肠癌平均风险的个体被纳入（2011-2012）。主要变量是参与BCCSP。根据临床风险组状态评估合并症。其他调整变量包括年龄、性别、社会经济剥夺、初级保健就诊、吸烟、饮酒和体重指数。使用逻辑回归模型来检验参与计划与潜在解释变量之间的关联。结果以发生率比（IRR）及其95%置信区间（CI）给出。在纳入的36,208人中，17,404人（48%）参加了BCCSP。妇女、60岁至64岁的个体、中度社会经济剥夺的患者和就诊次数较多的患者的参与率在统计上显著较高。在未参与组中，吸烟、高风险酒精摄入、肥胖和最高合并症类别的个体比例更高。在校正分析中，只有患有多种轻微慢性疾病的个体更有可能参与BCCSP （IRR 1.14; 95% CI [1.06 ~ 1.22]; p < 0.001）。相比之下，患有三种或三种以上显性慢性疾病的患者参与筛查计划的比例较低（IRR 0.76; 95% CI[0.65至0.89];p = 0.001）。患有三种或更多主要慢性疾病的人参与基于粪便免疫化学测试的结直肠癌筛查计划的程度较低，而患有多种轻微慢性疾病的人更有可能参与。需要进一步的研究来探索合并症作为不参加结直肠癌筛查计划的原因，以及哪些人可以从结直肠癌筛查中获益最多。
There is controversy regarding how comorbidity impacts on colorectal cancer screening, especially in the context of organised programmes. The aim of this study is to assess the effect of comorbidities on participation in the Barcelona population-based colorectal cancer screening programme (BCCSP). Cross-sectional study carried out in ten primary care centres involved in the BCCSP. Individuals aged 50 to 69, at average risk of colorectal cancer, who were invited to participate in the first round of the faecal immunochemical test-based BCCSP were included (2011–2012). The main variable was participation in the BCCSP. Comorbidity was assessed by clinical risk group status. Other adjusting variables were age, sex, socioeconomic deprivation, visits to primary care, smoking, alcohol consumption and body mass index. Logistic regression models were used to test the association between participation in the programme and potential explanatory variables. The results were given as incidence rate ratios (IRR) and their 95% confidence intervals (CI). Of the 36,208 individuals included, 17,404 (48%) participated in the BCCSP. Participation was statistically significantly higher in women, individuals aged 60 to 64, patients with intermediate socioeconomic deprivation, and patients with more medical visits. There was a higher rate of current smoking, high-risk alcohol intake, obesity and individuals in the highest comorbidity categories in the non-participation group. In the adjusted analysis, only individuals with multiple minor chronic diseases were more likely to participate in the BCCSP (IRR 1.14; 95% CI [1.06 to 1.22]; p < 0.001). In contrast, having three or more dominant chronic diseases was associated with lower participation in the screening programme (IRR 0.76; 95% CI [0.65 to 0.89]; p = 0.001). Having three or more dominant chronic diseases, was associated with lower participation in a faecal immunochemical test-based colorectal cancer screening programme, whereas individuals with multiple minor chronic diseases were more likely to participate. Further research is needed to explore comorbidity as a cause of non-participation in colorectal cancer screening programmes and which individuals could benefit most from colorectal cancer screening.
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影响因子：
4.4
作者：
Carrasco-Garrido, Pilar;Hernandez-Barrera, Valentin;Jimenez-Garcia, Rodrigo
通讯作者：
Jimenez-Garcia, Rodrigo
影响因子：
4.8
作者：
Borrell, Carme;Mari-Dell'Olmo, Marc;Gotsens, Merce
通讯作者：
Gotsens, Merce
影响因子：
3.8
作者：
Guiriguet-Capdevila, Carolina;Munoz-Ortiz, Laura;Toran-Monserrat, Pere
通讯作者：
Toran-Monserrat, Pere
影响因子：
24.5
作者：
Lo, Siu Hing;Halloran, Stephen;von Wagner, Christian
通讯作者：
von Wagner, Christian
影响因子：
3.9
作者：
Buron, Andrea;Grau, Jaume;Castells, Antoni
通讯作者：
Castells, Antoni