Acculturation and colorectal cancer screening among older Latino adults: differential associations by national origin.
Acculturation and colorectal cancer screening among older Latino adults: differential associations by national origin.
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DOI：
10.1007/s11606-009-1022-9
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发表时间：
2009-08
影响因子：
5.7
通讯作者：
Walsh, Judith M. E.
中科院分区：
文献类型：
--
作者：
Afable-Munsuz, Aimee;Liang, Su-Ying;Ponce, Ninez A.;Walsh, Judith M. E.
尽管结直肠癌（CRC）筛查的利用率有了一定程度的提高，但在拉丁裔人群中，这一比率仍然较低。文化适应是否在CRC筛查的利用中起作用尚不清楚。
本研究旨在探讨墨西哥裔、波多黎各裔和古巴裔老年人的文化适应与CRC筛查之间的关系。
横断面观察性研究。
年龄在50岁及以上、从未被诊断出患有CRC且在2000年、2003年和2005年全国健康访谈调查（NHIS）中接受调查的拉丁裔人群。
我们通过美国出生情况和访谈语言来衡量文化适应程度，并考察了三种不同的CRC筛查结果：过去一年的粪便潜血试验（FOBT）、最新的内镜检查以及任何最新的CRC筛查。逻辑回归模型根据倾向因素、使能因素和医疗需求因素进行了调整，这些因素与医疗利用行为模型一致。
在调整后的分析中，美国出生情况与墨西哥裔人群最新的内镜检查呈正相关（比值比：1.5；95%置信区间：1.1，2.2），但与波多黎各裔人群过去一年的FOBT呈负相关（比值比：0.3；95%置信区间：0.2，0.7）。与波多黎各裔人群的后一发现相反，英语访谈语言与过去一年的FOBT呈正相关（比值比：2.5；95%置信区间：1.1，5.4）。
研究结果强调了在文化适应和癌症筛查研究中按国籍进行分层的重要性，以及针对文化适应程度较低的成年人以促进CRC筛查的重要性。然而，临床医生应该考虑文化适应的复杂性，并将美国出生情况和语言偏好作为其拉丁裔患者的独立维度来对待。
Although modest improvements in colorectal cancer (CRC) screening utilization have occurred, rates remain low among Latinos. It is unclear whether acculturation plays a role in the utilization of CRC screening. This study aimed to examine the relationships between acculturation and CRC screening among older Mexican, Puerto-Rican and Cuban adults. Cross-sectional observational study. Latinos 50 years and older, never diagnosed with CRC, and who were surveyed in the 2000, 2003 and 2005 National Health Interview Survey (NHIS). We measured acculturation with US nativity and language of interview, and examined three different CRC screening outcomes: fecal occult blood test (FOBT) in the past year, up-to-date endoscopy and any up-to-date CRC screening. Logistic regression models were adjusted for predisposing, enabling and health-care need factors consistent with the behavioral model of health-care utilization. In adjusted analyses, US nativity was positively associated with up-to-date endoscopy among Mexicans (OR: 1.5; 95% CI: 1.1, 2.2), but negatively associated with FOBT in the past year among Puerto Ricans (OR: 0.3; 95% CI: 0.2, 0.7). In contrast to this latter finding among Puerto Ricans, English language interview was positively associated with FOBT in the past year (OR: 2.5; 95% CI: 1.1, 5.4). Results underscore the importance of stratification by national origin in studies of acculturation and cancer screening and of targeting less acculturated adults to promote CRC screening. Clinicians, however, should consider the complexity of acculturation and treat US nativity and language preference as independent dimensions among their Latino patients.
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