Colorectal cancer screening mode preferences among US veterans
Colorectal cancer screening mode preferences among US veterans
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DOI：
10.1016/j.ypmed.2009.09.002
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发表时间：
2009-11-01
影响因子：
5.1
通讯作者：
Partin, Melissa R.
中科院分区：
文献类型：
--
作者：
Powell, Adam A.;Burgess, Diana J.;Partin, Melissa R.
Objective.评估结直肠癌（CRC）筛查模式的偏好和这些偏好的相关性，在美国退伍军人中的平均风险CRC。在2005年1月至2006年12月期间，对VA患者的全国代表性样本进行了横断面调查。我们报告了2068名平均风险退伍军人和基于个人、行为和环境因素的患者亚组对筛查模式的偏好分布。通过分层逻辑回归模型确定了偏好的独立预测因素。结肠镜检查（37%）是最首选的方式，其次是粪便潜血试验（FOBT）（29%）。最强的预测偏好是以前的筛选经验，提供者的建议，并使用非VA医疗服务。社会经济地位较高的参与者更有可能选择结肠镜检查，而不太可能表示没有偏好。仅提供一种模式的筛查程序不能适应相当大比例的患者的偏好。在VA内，将筛查结肠镜检查添加到目前仅提供FOBT的项目中可能会增加对结肠镜检查的偏好，因为患者将提供者的建议和结肠镜检查的个人经验纳入他们的偏好中。这可能会不成比例地使目前无法获得非VA结肠镜检查服务的较低社会经济群体受益。爱思唯尔公司出版
Objective. To assess colorectal cancer (CRC) screening mode preferences and correlates of these preferences among US veterans at average risk for CRC.Method. A cross-sectional survey of a nationally representative sample of VA patients was conducted between January 2005 and December 2006. We report preference distributions for screening modes among 2068 average-risk veterans and across patient subgroups based on personal, behavioral, and environmental factors. Independent predictors of preferences are identified through hierarchical logistic regression models.Results. Colonoscopy (37%) was the most preferred mode followed by fecal occult blood test (FOBT) (29%). The strongest predictors of preferences were previous screening experience, provider recommendation, and use of non-VA healthcare services. Participants in higher socioeconomic groups were more likely to choose colonoscopy and less likely to indicate no preference.Conclusion. screening programs that offer only one mode fail to accommodate the preferences of a substantial proportion of patients. Within the VA, adding screening colonoscopy to programs currently offering only FOBT is likely to increase preferences for colonoscopy, as patients incorporate provider recommendations for and personal experience with colonoscopy into their preferences. This is likely to disproportionately benefit lower socioeconomic groups who do not currently have access to non-VA colonoscopy services. Published by Elsevier Inc.