Colonoscopy screening among US adults aged 40 or older with a family history of colorectal cancer.
Colonoscopy screening among US adults aged 40 or older with a family history of colorectal cancer.
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DOI：
10.5888/pcd12.140533
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发表时间：
2015-05-21
影响因子：
5.5
通讯作者：
de Groen PC
中科院分区：
文献类型：
--
作者：
Tsai MH;Xirasagar S;Li YJ;de Groen PC
结肠镜检查可降低结直肠癌（CRC）的发病率和死亡率。对于一般风险人群，建议在50岁时进行结直肠癌筛查。建议对结直肠癌患者的一级亲属进行筛查，筛查时间为40岁或比最年轻的亲属确诊为结直肠癌的年龄早10年。近年来，美国年轻人的结直肠癌发病率有所上升，而老年人的发病率则有所下降。本研究的目的是确定CRC患者的一级亲属是否按照推荐的指南进行筛查。我们使用2005年和2010年全国健康访谈调查数据研究了有结直肠癌家族史的美国人群的结肠镜筛查率。在26,064名符合研究条件的受访者中，2,470人报告有CRC家族史；在有家族史的人群中，45.6%的人做过结肠镜检查（2005年为25.2%，2010年为65.8%）。2010年40 ~ 49岁一级亲属结肠镜检查率（38.3%）约为50岁及以上一级亲属（69.7%）的一半。一级亲属接受结肠镜检查的可能性是非一级亲属的近两倍（校正优势比[AOR]为1.7；95%可信区间为1.5-1.9），但年龄在40 - 49岁的患者接受结肠镜检查的可能性低于年龄较大的人群（50-64岁的AOR为2.6；年龄≥65岁的AOR为3.6）。与年龄、保险和种族/民族的相互作用不显著。拥有健康保险的人接受筛查的可能性增加了两倍。尽管自2005年以来结肠镜筛查率增加了5倍，但低于常规筛查年龄的一级亲属的筛查率却有所下降。针对这一群体的筛查推广可能会阻止最近在美国年轻人中CRC上升的趋势。
Colonoscopy screening reduces colorectal cancer (CRC) incidence and mortality. CRC screening is recommended at age 50 for average-risk people. Screening of first-degree relatives of CRC patients is recommended to begin at age 40 or 10 years before the age at diagnosis of the youngest relative diagnosed with CRC. CRC incidence has increased recently among younger Americans while it has declined among older Americans. The objective of this study was to determine whether first-degree relatives of CRC patients are being screened according to recommended guidelines. We studied colonoscopy screening rates among the US population reporting a CRC family history using 2005 and 2010 National Health Interview Survey data. Of 26,064 study-eligible respondents, 2,470 reported a CRC family history; of those with a family history, 45.6% had a colonoscopy (25.2% in 2005 and 65.8% 2010). The colonoscopy rate among first-degree relatives aged 40 to 49 in 2010 (38.3%) was about half that of first-degree relatives aged 50 or older (69.7%). First-degree relatives were nearly twice as likely as nonfirst-degree relatives to have a colonoscopy (adjusted odds ratio [AOR], 1.7; 95% confidence interval, 1.5–1.9), but those aged 40 to 49 were less likely to have a colonoscopy than those in older age groups (AOR, 2.6 for age 50–64; AOR, 3.6 for age ≥65). Interactions with age, insurance, and race/ethnicity were not significant. Having health insurance tripled the likelihood of screening. Despite a 5-fold increase in colonoscopy screening rates since 2005, rates among first-degree relatives younger than the conventional screening age have lagged. Screening promotion targeted to this group may halt the recent rising trend of CRC among younger Americans.
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影响因子：
16.9
作者：
Bailey CE;Hu CY;You YN;Bednarski BK;Rodriguez-Bigas MA;Skibber JM;Cantor SB;Chang GJ
通讯作者：
Chang GJ
影响因子：
8.4
作者：
Butterworth, AS;Higgins, JPT;Pharoah, P
通讯作者：
Pharoah, P
DOI：
10.1093/jnci/85.7.566
发表时间：
1993-04-07
期刊：
JOURNAL OF THE NATIONAL CANCER INSTITUTE
影响因子：
--
作者：
GORDON, NP;HIATT, RA;LAMPERT, DI
通讯作者：
LAMPERT, DI
影响因子：
120.7
作者：
Gross, Cary P.;Andersen, Martin S.;Tinetti, Mary E.
通讯作者：
Tinetti, Mary E.
影响因子：
2.3
作者：
Matthews, BA;Anderson, RC;Nattinger, AB
通讯作者：
Nattinger, AB