Breast and bowel cancer screening uptake patterns over 15 years for UK south Asian ethnic minority populations, corrected for differences in socio-demographic characteristics.
Breast and bowel cancer screening uptake patterns over 15 years for UK south Asian ethnic minority populations, corrected for differences in socio-demographic characteristics.
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DOI：
10.1186/1471-2458-8-346
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发表时间：
2008-10-02
影响因子：
4.5
通讯作者：
Gumber, Anil
中科院分区：
文献类型：
--
作者：
Szczepura, Ala;Price, Charlotte;Gumber, Anil
一些研究报告说，英国南亚人口对癌症筛查计划的接受率很低。然而，迄今为止的研究尚未调整这些人群的人口统计学和社会经济地位差异的结果。受试者：英国考文垂和沃里克郡符合筛选条件的所有居民。比较了第一轮（2000 - 2002年）和第二轮（2003 - 2005年）国家肠癌筛查试点项目以及第一、第二和第五轮国家卫生服务体系乳腺癌筛查方案（1989年开始）的接受情况。数据：在第一轮中分析了123，367名受邀者的肠道筛查数据，在第二轮中分析了116，773名受邀者（共240，140例）。在第一、第二和第五轮分别分析了61 934、62 829和86 749名受邀者的乳房筛查数据（共211 512例）。分析：比较了两个大元类别（南亚和非亚洲）和五个亚洲亚组（印度-古吉拉特;印度-其他;穆斯林;锡克教徒;南亚其他）的筛查摄取。单变量和多变量分析检查了筛查摄取率和受邀者的各种人口统计学属性，包括年龄，性别，贫困和种族群体。南亚人表现出显著较低（p <0.001）的未经调整的肠道筛查摄取; 32.8%对非亚洲人的61.3%（第1轮）。穆斯林亚组的比例特别低：26.1%（第一轮），21.5%（第二轮）。对于乳腺筛查，南亚人和非亚洲人之间的差异较小;最初为60.8% vs. 75.4%（第1轮），后来为66.8% vs. 77.7%（第5轮）。因此，随着时间的推移，差距逐渐缩小，同时总体趋势是增加吸收。然而，穆斯林的数字仍然很低（第1轮和第5轮为51%）。在调整了年龄、剥夺（和性别）后，所有南亚亚组的肠道筛查摄取率仍显着较低。经过类似的调整后，除印度古吉拉特邦人外，所有亚组的乳腺筛查摄取率均较低。对于在亚洲（与非亚洲）GP注册的穆斯林，肠道筛查摄取显著较低（p <0.001）。然而，在同一时期，亚裔穆斯林（与非亚裔）GP的乳腺筛查摄取率没有差异（p = 0.12）。结肠镜检查和乳房评估摄取量在两个元类别中相似，但亚洲人结肠镜检查的反应时间似乎较慢。南亚受邀者的异常FOBT结果百分比显著较高。随着时间的推移，穆斯林的乳房X光检查异常率略有增加（第1轮和第5轮分别为2.7%至4.2%）。在南亚人群中观察到的较低的癌症筛查摄取率不能归因于社会经济、年龄或性别人群差异。虽然乳房筛查的差异随着时间的推移而减少，但仍然存在显着差异。我们的结论是，这两个方案都需要实施和评估干预措施，以减少这种差异。
A number of studies have reported low uptake of cancer screening programmes by South Asian populations in the UK. However, studies to date have not adjusted findings for differences in demographics and socio-economic status of these populations. Subjects: All residents in Coventry and Warwickshire, UK, eligible for screening. Uptakes compared for round 1 (2000–02) and round 2 (2003–05) of a national bowel cancer screening pilot, and for rounds 1, 2 and 5 of the established NHS breast cancer screening programme (commenced 1989). Data: Bowel screening data were analysed for 123,367 invitees in round 1 and 116,773 in round 2 (total 240,140 cases). Breast screening data were analysed for 61,934, 62,829 and 86,749 invitees in rounds 1, 2 and 5 respectively (total 211,512 cases). Analysis: Screening uptake was compared for two broad meta-categories (South Asian and non-Asian) and for five Asian subgroups (Hindu-Gujarati; Hindu-Other; Muslim; Sikh; South Asian Other). Univariate and multivariate analyses examined screening uptake and various demographic attributes of invitees, including age, gender, deprivation and ethnic group. South Asians demonstrated significantly lower (p < 0.001) unadjusted bowel screening uptake; 32.8% vs. 61.3% for non-Asians (round 1). Rates were particularly low for the Muslim subgroup: 26.1% (round 1), 21.5% (round 2). For breast screening, a smaller difference was observed between South Asians and non-Asians; initially 60.8% vs. 75.4% (round 1) and later 66.8% vs. 77.7% (round 5). Thus, the disparity reduced gradually over time, alongside an overall trend of increased uptake. However, figures remained consistently low for Muslims (51% in rounds 1 and 5). After adjusting for age, deprivation (and gender), bowel screening uptake remained significantly lower for all South Asian subgroups. After similar adjustments, breast screening uptake remained lower for all subgroups except Hindu-Gujaratis. For Muslims registered with an Asian (vs. non-Asian) GP, bowel screening uptake was significantly lower (p < 0.001). However, breast screening uptake for Muslims with an Asian (vs. non-Asian) GP showed no difference (p = 0.12) in the same period. Colonoscopy and breast assessment uptakes were similar for both meta-categories, but Asian response time appeared slower for colonoscopy. The percentage of abnormal FOBT results was significantly higher for South Asian invitees. A slight increase in abnormal mammograms was observed for Muslims over time (2.7% to 4.2% in rounds 1 and 5 respectively). The lower cancer screening uptakes observed for the South Asian population cannot be attributed to socio-economic, age or gender population differences. Although breast screening disparities have reduced over time, significant differences remain. We conclude that both programmes need to implement and assess interventions to reduce such differences.
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影响因子：
2.9
作者：
Bennett, R. L.;Blanks, R. G.;Moss, S. M.
通讯作者：
Moss, S. M.
影响因子：
5.1
作者：
Brenes, GA;Paskett, ED
通讯作者：
Paskett, ED
影响因子：
12.7
作者：
CALLE, EE;FLANDERS, WD;MARTIN, LM
通讯作者：
MARTIN, LM
影响因子：
3
作者：
Baker, David W.;Hasnain-Wynia, Romana;Brown, E. Richard
通讯作者：
Brown, E. Richard
影响因子：
254.7
作者：
BORING, CC;SQUIRES, TS;HEATH, CW
通讯作者：
HEATH, CW