Adherence to colorectal cancer screening in an HMO population.
Adherence to colorectal cancer screening in an HMO population.
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HMO 人群中坚持结直肠癌筛查。
DOI：
10.1016/0091-7435(90)90049-p
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发表时间：
1990
影响因子：
5.1
通讯作者：
Engstrom,PF
中科院分区：
文献类型：
--
作者：
Myers,RE;Trock,BJ;Lerman,C;Wolf,T;Ross,E;Engstrom,PF
本研究旨在确定影响结直肠癌筛查中粪便潜血试验性能的因素。随机抽取年龄在50岁至74岁之间的男性和女性样本，他们在1986年秋季的筛查计划中邮寄了粪便潜血检测试剂盒。一年后，初步测试邮寄，样本组成员（n= 504）进行了电话调查。四个月后，调查样本收到了第二次粪便潜血检测邮寄。对既往粪便潜血试验状态经验证的受试者（n= 322）进行多变量分析，结果显示，既往试验与医生鼓励筛查、年龄、癌症可治愈的信念、感知的试验疗效和进行试验的强烈意愿呈正相关。研究还发现，那些认为自己对自己的健康几乎没有控制权的人不太可能做过测试。对前瞻性依从性的初步分析表明，最强的统计学显著独立预测因子是过去的测试表现。在过去的非测试者（n= 121）中，前瞻性的依从性与明确承诺进行粪便潜血测试和报告存在结直肠癌风险因素有关。对过去测试者（n= 201）的依从性分析显示，对结直肠癌可治愈性的信念和年龄是重要的预测因素。这里报告的研究结果表明，影响过去的nontesters之间的依从性的因素与过去的测试者不同。总体而言，这些结果表明，为了增加对结直肠癌筛查的参与，医生和其他卫生专业人员应该（a）提供教育信息，提高对结直肠癌风险因素和疾病可治愈性的认识，（B）促使潜在的筛查对象承诺采取推荐的预防行为。通过强调结直肠癌的危险因素和突出可治愈性，也可以考虑分别为过去的非测试者和过去的测试者“定制”信息。
This study aimed to determine factors that influence fecal occult blood test performance in colorectal cancer screening. A random sample was selected of men and women ages 50 to 74 years of age who had been mailed a fecal occult blood testing kit in a screening program in fall 1986. One year after initial test mailing, sample group members (n= 504) were surveyed by telephone. Four months later, the survey sample received a second fecal occult blood test mailing. Multivariable analysis for subjects with validated past fecal occult blood test status (n= 322) revealed that past testing was positively associated with physician encouragement of screening, age, the belief that cancer is curable, perceived test efficacy, and strong intention to do testing. It also was discovered that persons who felt that they had little control over their health were not likely to have done past testing. Preliminary analysis of prospective adherence showed that the strongest statistically significant independent predictor was past test performance. Prospective adherence among past nontesters (n= 121) was associated with expressed commitment to do fecal occult blood testing and reported presence of colorectal cancer risk factors. Analysis of adherence among past testers (n= 201) revealed that belief in colorectal cancer curability and age were significant predictors. The findings reported here indicate that factors influencing adherence among past nontesters differ from those for past testers. Overall, these results suggest that to increase participation in colorectal cancer screening, physicians and other health professionals should (a) deliver educational messages that increase awareness of risk factors for colorectal cancer and curability of the disease, and (b) elicit from potential screenees a commitment to engage in recommended preventive behaviors. It may also be well to consider “tailoring” messages for past nontesters and past testers, respectively, by emphasizing colorectal cancer risk factors and highlighting curability.