Colorectal cancer screening in the United States: Trends from 2008 to 2015 and variation by health insurance coverage.
Colorectal cancer screening in the United States: Trends from 2008 to 2015 and variation by health insurance coverage.
复制标题
DOI：
10.1016/j.ypmed.2018.05.001
复制
发表时间：
2018-07
影响因子：
5.1
通讯作者：
Klabunde CN
中科院分区：
文献类型：
--
作者：
de Moor JS;Cohen RA;Shapiro JA;Nadel MR;Sabatino SA;Robin Yabroff K;Fedewa S;Lee R;Paul Doria-Rose V;Altice C;Klabunde CN
建议定期进行结直肠癌筛查，以降低结直肠癌的发病率和死亡率。本文提供了美国结直肠癌筛查的最新分析，并通过健康保险覆盖范围的几个特征检查了结直肠癌筛查。使用国家健康访谈调查的数据，在2008年、2010年、2013年和2015年对50-75岁的成年人计算了符合建议的CRC筛查。对2015年的CRC筛查流行率进行了总体描述，并按社会人口亚组进行了说明。进一步使用多变量Logistic回归分析，按年龄(50-年龄和65-75岁)分层，并根据年龄、种族/民族、性别、教育程度、收入、在美国的时间和合并情况进行调整。推荐一致性筛查从2008年的51.6%上升到2010年的58.3%(p<；0.001)。从2010年到2013年，手机使用量持平，但在2015年上升到61.3%(p<；0.001)。2015年，拥有传统雇主赞助私人保险的50岁至年龄段的成年人更有可能接受筛查(62.2%)，高于拥有传统私人直接购买计划的成年人(50.9%)和未参保的成年人(24.8%)(P<；0.01)。在多变量调整后，传统雇主赞助的私人保险与未投保的人之间的差异在统计学上仍然显著。有医疗保险和私人保险的65-75岁成年人接受筛查的可能性(76.3%)高于没有补充保险的成年人(68.8%)或有医疗保险和医疗补助的成年人(65.2%)(p<；0.001)。在多变量调整后，医疗保险与私人保险以及医疗保险与非补充保险之间的差异仍然具有统计学意义。随着时间的推移，CRC筛查率有所上升，但某些人群，特别是未参保的人群，筛查继续低于建议的水平。
Regular colorectal cancer (CRC) screening is recommended for reducing CRC incidence and mortality. This paper provides an updated analysis of CRC screening in the United States (US) and examines CRC screening by several features of health insurance coverage. Recommendation-consistent CRC screening was calculated for adults aged 50–75 in 2008, 2010, 2013 and 2015 using data from the National Health Interview Survey. CRC screening prevalence in 2015 was described overall and by sociodemographic subgroups. CRC screening by health insurance coverage was further examined using multivariable logistic regression, stratified by age (50–64 years and 65–75 years) and adjusted for age, race/ethnicity, sex, education, income, time in US, and comorbid conditions. Recommendation-consistent screening increased from 51.6% in 2008 to 58.3% in 2010 (p < 0.001). Use plateaued from 2010 to 2013 but increased to 61.3% in 2015 (p < 0.001). In 2015, adults aged 50–64 years with traditional employer-sponsored private insurance were more likely to be screened (62.2%) than those with traditional private direct purchase plans (50.9%) and the uninsured (24.8%) (p < 0.01, respectively). After multivariable adjustment, differences between traditional employer-sponsored private insurance and the uninsured remained statistically significant. Adults aged 65–75 with Medicare and private insurance were more likely to be screened (76.3%) than those with Medicare, no supplemental insurance (68.8%) or Medicare and Medicaid (65.2%) (p < 0.001). After multivariable adjustment, the differences between Medicare and private insurance and Medicare no supplemental insurance remained statistically significant. CRC screening rates have increased over time, but certain segments of the population, especially the uninsured, continue to screen below recommended levels.
登录
查看更多内容
影响因子：
--
作者：
Inadomi, John M.;Vijan, Sandeep;Janz, Nancy K.;Fagerlin, Angela;Thomas, Jennifer P.;Lin, Yunghui V.;Munoz, Roxana;Lau, Chim;Somsouk, Ma;El-Nachef, Najwa;Hayward, Rodney A.
通讯作者：
Hayward, Rodney A.
影响因子：
2.3
作者：
Miranda, Patricia Y.;Yao, Nengliang;Hillemeier, Marianne M.
通讯作者：
Hillemeier, Marianne M.
影响因子：
3
作者：
Reddy SR;Ross-Degnan D;Zaslavsky AM;Soumerai SB;Wharam JF
通讯作者：
Wharam JF
影响因子：
3
作者：
Wharam, J. Frank;Zhang, Fang;Ross-Degnan, Dennis
通讯作者：
Ross-Degnan, Dennis
影响因子：
254.7
作者：
Siegel, Rebecca L.;Miller, Kimberly D.;Jemal, Ahmedin
通讯作者：
Jemal, Ahmedin