Increasing deaths from colorectal cancer in Poland - Insights for optimising colorectal cancer screening in society and space
Increasing deaths from colorectal cancer in Poland - Insights for optimising colorectal cancer screening in society and space
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DOI：
10.26444/aaem/99233
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发表时间：
2019-01-01
影响因子：
1.7
通讯作者：
Czaderny, Krzysztof
中科院分区：
文献类型：
--
作者：
Czaderny, Krzysztof
导言和目标。关于在波兰由于结直肠癌死亡人数的增加，本研究的目的是调查社会人口学特征，影响结直肠癌筛查接受和评估结直肠癌死亡率的空间变异。估计年龄-时期-队列模型以评估波兰结直肠癌的死亡率趋势。通过空间回归进行地理分析。采用结构方程模型对影响参与结直肠癌筛查的因素进行了分析。2014年，波兰有6400名男性和5000名女性死于结直肠癌。总的来说，到2030年，这一数字预计将上升到近1.44万。观察到的年龄校正结直肠癌死亡率的空间聚集与烟草使用、工业就业和红肉消费的空间变化相关。医患沟通、高龄和健康饮食是结直肠癌筛查接受度的最重要预测因素。调整其他变量后，吸烟和饮酒者并不更可能参与结直肠癌筛查。遵循健康饮食的患者的自我选择意味着结直肠癌风险较高的个体不太可能参加结直肠癌筛查。因此，筛查应更具针对性。根据结构方程模型的结果，“不显示”的现象可以减轻筛选的病人和医生的沟通。大波兰地区的居民死于结直肠癌的风险最高，这可能会对公共卫生政策产生影响。
Introduction and objective. With respect to the increasing numbers of deaths due to colorectal cancer in Poland, the aim of the study was to investigate socio-demographic characteristics which influence colorectal cancer screening acceptance and to assess spatial variation of colorectal cancer mortality.Materials and method. An age-period-cohort model was estimated to assess mortality trends in colorectal cancer in Poland. A geographical analysis was performed by spatial regression. Factors influencing participation in colorectal cancer screening were identified using structural equation modelling.Results. In 2014 in Poland, 6.4 thousand men and 5.0 thousand women died due to colorectal cancer. In total, by 2030 this number is expected to rise to nearly 14.4 thousand. Observed spatial clustering of age-adjusted colorectal cancer mortality is associated with spatial variation in tobacco use, employment in industry, and consumption of red meat. Patientphysician communication, advanced age, and healthy diet are the most important predictors of colorectal cancer screening acceptance. Tobacco and alcohol users are not more likely to participate in colorectal cancer screening, adjusting for other variables.Conclusions. Self-selection of patients who follow healthy diet means that individuals at higher risk of colorectal cancer are less likely to participate in colorectal cancer screening. Therefore, screening should be more targeted. According to the structural equation modelling results, the phenomenon of 'no-show' for screening can be mitigated by patient-physician communication. The inhabitants of the Greater Poland region are at the highest risk of dying due to colorectal cancer, which may have public health policy implications.