Trends in colorectal cancer screening over time for persons with and without chronic disability
Trends in colorectal cancer screening over time for persons with and without chronic disability
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DOI：
10.1016/j.dhjo.2016.02.003
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发表时间：
2016-07-01
影响因子：
4.5
通讯作者：
Rao, Sowmya R.
中科院分区：
文献类型：
--
作者：
Iezzoni, Lisa I.;Kurtz, Stephen G.;Rao, Sowmya R.
背景：残疾人在常规癌症筛查中经常遇到差异。然而，有了1990年《美国残疾人法案》对公民权利的保护，这种差异可能会随着时间的推移而缩小。目的：检查结直肠癌筛查中是否存在残疾差异，以及这些筛查模式是否随着时间的推移而改变。方法：我们分析了1998至2010年间选定年份50-75岁的非制度化美国平民的国家健康访谈调查回应。我们使用自我报告的功能障碍、活动/参与限制和预期持续时间确定了7个慢性残疾指标。对于女性和男性，我们分别进行了双变量和多变量Logistic回归分析，考察了自我报告的结直肠癌筛查服务与社会人口学因素和残疾类型的关系。结果：慢性残疾的模式在女性和男性之间有所不同；随着时间的推移，残疾比率普遍上升。从1998年到2010年，女性和男性的结直肠癌筛查率都大幅上升。随着时间的推移，非残障人士和各种残障人士之间的结直肠癌筛查率在统计学上的显著差异相对较少。2010年，报告的筛查率在非残疾人和残疾人之间大致相当。在少数有统计学意义的差异中，残疾人报告的结直肠癌筛查率几乎总是高于非残疾人。结论：根据国家调查数据，报告的结直肠癌筛查在非残疾人和各种不同残疾类型的个人之间是相似的。尽管一些结直肠癌筛查测试对身体有要求，但残疾人群和非残疾人群之间并不存在差异。(C)2016 Elsevier Inc.保留所有权利。
Background: Persons with disabilities have often experienced disparities in routine cancer screening. However, with civil rights protections from the 1990 Americans with Disabilities Act, such disparities may diminish over time.Objective: To examine whether disability disparities exist for colorectal cancer screening and whether these screening patterns have changed over time.Methods: We analyzed National Health Interview Survey responses from civilian, non-institutionalized U.S. residents 50-75 years old from selected years between 1998 and 2010. We specified 7 chronic disability indicators using self-reported functional impairments, activity/participation limitations, and expected duration. Separately for women and men, we conducted bivariable and multivariable logistic regression analyses examining associations of self-reported colorectal cancer screening services with sociodemographic factors and disability type.Results: Patterns of chronic disability differed somewhat between women and men; disability rates generally rose over time. For both women and men, colorectal cancer screening rates increased substantially from 1998 through 2010. Over time, relatively few statistically significant differences were reported in colorectal cancer screening rates between nondisabled persons and individuals with various disabilities. In 2010, reported screening rates were generally comparable between nondisabled and disabled persons. In the few statistically significant differences, persons with disabilities almost always reported higher colorectal cancer screening rates than nondisabled individuals.Conclusions: According to national survey data, reported use of colorectal cancer screening is similar between nondisabled persons and individuals with a variety of different disability types. Despite physical demands of some colorectal cancer screening tests, disparities do not appear between populations with and without disability. (C) 2016 Elsevier Inc. All rights reserved.