Colorectal cancer screening attitudes and behavior: A population-based study
Colorectal cancer screening attitudes and behavior: A population-based study
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DOI：
10.1016/j.ypmed.2003.09.016
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发表时间：
2003-12-01
影响因子：
5.1
通讯作者：
Guire, KE
中科院分区：
文献类型：
--
作者：
Janz, NK;Wren, PA;Guire, KE
背景。尽管建议对50岁或50岁以上的人进行结直肠癌（CRC）筛查以降低结直肠癌死亡率，但筛查率仍然低得令人不安。采用随机数字拨号法，对居住在密歇根州杰内西县的年龄在50-79岁的黑人和白人男女进行了355次电话采访。健康信念模型为评估CRC筛查的态度和实践提供了框架。对于这两种内镜检查，白人知晓筛查程序的比例明显高于黑人（P < 0.05）。总体而言，只有不到30%的应答者遵守了当前的CRC筛查指南。黑人女性的依从性最低：粪便隐血检查21%，乙状结肠镜检查20%，结肠镜检查12%。黑人男性接受柔性乙状结肠镜检查或结肠镜检查的可能性是黑人女性的2.8倍（P < 0.05）。医生的建议是筛查的有力动力。筛查的两个一贯障碍是认为：(a)不需要检测；(b)测试令人尴尬。针对医生和患者的干预措施对于提高结直肠癌筛查率至关重要。通过医生指导下的筛查，重点关注已发现的障碍，可以提高结直肠癌的生存率。(C) 2003年美国卫生基金会和爱思唯尔科学（美国）。版权所有。
Background. Even though colorectal cancer (CRC) screening tests for persons 50 years of age or over are recommended to reduce colorectal cancer mortality, screening rates remain disturbingly low.Methods. Using random digit dialing, 355 telephone interviews were conducted with black and white men and women, 50-79 years of age, who resided in Genesee County, Michigan. The Health Belief Model provided the framework to assess attitudes and practices regarding CRC screening.Results. For both endoscopic procedures, significantly higher percentages of whites than blacks were aware of the screening procedure (P < 0.05). Overall, fewer than 30% of respondents were adherent to current CRC screening guidelines. Adherence was lowest for black females: 21% for fecal occult blood test, 20% for flexible sigmoidoscopy, and 12% for colonoscopy. Black males compared to black females were about 2.8 times more likely to have had either flexible sigmoidoscopy or colonoscopy (P < 0.05). Physician recommendation was a powerful motivator to screening. Two consistent barriers to screening were the belief that: (a) the test is not needed; and (b) the test is embarrassing.Conclusions. Interventions directed at physicians and patients are essential to enhance CRC screening rates. CRC survival rates may be improved by physician-guided promotion of screening that focuses on identified barriers. (C) 2003 American Health Foundation and Elsevier Science (USA). All rights reserved.