Progress in cancer screening over a decade: Results of cancer screening from the 1987, 1992, and 1998 National Health Interview Surveys
Progress in cancer screening over a decade: Results of cancer screening from the 1987, 1992, and 1998 National Health Interview Surveys
复制标题
DOI：
10.1093/jnci/93.22.1704
复制
发表时间：
2001-11-21
期刊：
影响因子：
--
通讯作者：
Ballard-Barbash, R
中科院分区：
文献类型：
--
作者：
Breen, N;Wagener, DK;Ballard-Barbash, R
背景：早期发现癌症的筛查是一项日益重要的癌症控制活动，除非得到广泛应用，否则不会有效。方法：在 1987 年、1992 年和 1998 年国家健康访谈调查中评估了子宫颈抹片检查、乳房 X 光检查、粪便隐血试验 (FOBT)、乙状结肠镜检查和直肠指检 (DRE) 的使用情况。按性别、年龄检查筛查使用的水平和趋势；和种族/族裔群体。在年龄组内研究了收入、教育水平和医疗保健覆盖范围的影响。使用 1998 年数据的逻辑回归分析来开发一个简约的、与政策相关的模型。结果：在检查期间，所有筛查方式的使用有所增加；对于乳房X光检查和DRE，这十年的前五年增长更快；对于巴氏试验和乙状结肠镜检查，在本世纪后半叶增长得更快。 1998 年结直肠癌筛查（乙状结肠镜检查和 FOBT）水平低于十年前乳房 X 光检查的水平。所有筛查方式的变化模式因年龄、性别和种族/族裔群体而异，但在研究期间，在建议的时间间隔内，收入较低和受教育程度较低的群体的使用率始终较低。逻辑回归分析表明，当考虑到年龄、性别、种族/族裔群体和教育水平时，保险范围以及在更大程度上通常的护理来源与筛查使用具有很强的独立相关性。结论：虽然美国的癌症筛查普遍增加，但结直肠癌筛查以及缺乏健康保险或常规护理来源的群体的使用率相对较低。
Background: Screening to detect cancer early, an increasingly important cancer control activity, cannot be effective unless it is widely used. Methods: Use of Pap smears, mammography, fecal occult blood tests (FOBTs), sigmoidoscopy, and digital rectal examination (DRE) was evaluated in the 1987, 1992, and 1998 National Health Interview Surveys. Levels and trends in screening use were examined by sex, age; and racial/ethnic group. The effects of income, educational level, and health care coverage were examined within age groups. Logistic regression analyses of 1998 data were used to develop a parsimonious, policy-relevant model. Results: Use of all screening modalities increased over the period examined; for mammography and DRE, the increase was more rapid in the first half of the decade; for the Pap test and sigmoidoscopy, the increase was more rapid in the second half of the decade. Levels of colorectal cancer screening (both sigmoidoscopy and FOBTs) in 1998 were less than the level that prevailed a decade earlier for mammography. Patterns of change for all screening modalities differed between age, sex, and racial/ethnic groups, but prevalence of use during the study, within recommended time intervals, was consistently lower among groups with lower income and less education. Logistic regression analyses indicated that insurance coverage and, to a greater extent, usual source of care had strong independent associations with screening usage when age, sex, racial/ethnic group, and educational level were taken into account. Conclusions: While cancer screening is generally increasing in the United States, usage is relatively low for colorectal cancer screening and among groups that lack health insurance or a usual source of care.