Trends in Colorectal Cancer Test Use among Vulnerable Populations in the United States
Trends in Colorectal Cancer Test Use among Vulnerable Populations in the United States
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DOI：
10.1158/1055-9965.epi-11-0220
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发表时间：
2011-08-01
影响因子：
3.8
通讯作者：
Nadel, Marion R.
中科院分区：
文献类型：
--
作者：
Klabunde, Carrie N.;Cronin, Kathleen A.;Nadel, Marion R.
背景资料：评估结直肠癌（CRC）筛查使用的趋势对于了解筛查实施以及筛查的目标人群是否正在接受筛查，与指南一致至关重要。本研究探讨了最近的国家趋势，CRC测试使用，包括在弱势population.Methods：我们使用了2000年，2003年，2005年和2008年全国健康访谈调查，检查全国趋势CRC筛查使用的整体和粪便潜血试验（FOBT），乙状结肠镜检查，结肠镜检查。我们还评估了种族/民族，受教育程度，收入，在美国的时间，并获得healthcare.Results的趋势：在2000年至2008年期间，FOBT和乙状结肠镜检查的使用显着下降，结肠镜检查的使用显着增加，并在成年人的比例高达最新的CRC筛查发生的整体和大多数人口亚组。结肠镜检查使用率持续较低且最新的亚组包括西班牙裔;受教育程度最低，收入低或没有健康保险的人;最近的移民;以及过去一年没有常规护理或医生就诊的人。在最新的成年人中，他们最新的测试类型几乎没有亚组差异（即，结论：尽管在美国成年人中，包括弱势人群，CRC筛查和结肠镜检查的使用有所增加，但在2008年，45%的50至75岁的成年人-或近3500万人-没有进行最新的筛查。在美国所有人群中，仍然需要提高CRC筛查率。癌症流行病学生物标志物Prev; 20（8）; 1611-21。（C）2011年《非洲标准化评论》。
Background: Evaluating trends in colorectal cancer (CRC) screening use is critical for understanding screening implementation, and whether population groups targeted for screening are receiving it, consistent with guidelines. This study examines recent national trends in CRC test use, including among vulnerable populations.Methods: We used the 2000, 2003, 2005, and 2008 National Health Interview Survey to examine national trends in CRC screening use overall and for fecal occult blood test (FOBT), sigmoidoscopy, and colonoscopy. We also assessed trends by race/ethnicity, educational attainment, income, time in the United States, and access to health care.Results: During 2000 to 2008, significant declines in FOBT and sigmoidoscopy use and significant increases in colonoscopy use and in the percentages of adults up-to-date with CRC screening occurred overall and for most population subgroups. Subgroups with consistently lower rates of colonoscopy use and being up-to-date included Hispanics; people with minimal education, low income, or no health insurance; recent immigrants; and those with no usual source of care or physician visits in the past year. Among up-to-date adults, there were few subgroup differences in the type of test by which they were up-to-date (i.e., FOBT, sigmoidoscopy, or colonoscopy).Conclusions: Although use of CRC screening and colonoscopy increased among U.S. adults, including those from vulnerable populations, 45% of adults aged 50 to 75-or nearly 35 million people-were not up-to-date with screening in 2008.Impact: Continued monitoring of CRC screening rates among population subgroups with consistently low utilization is imperative. Improvement in CRC screening rates among all population groups in the United States is still needed. Cancer Epidemiol Biomarkers Prev; 20(8); 1611-21. (C)2011 AACR.