Prevalence of colorectal cancer screening among a multimorbid rural Appalachian population.
Prevalence of colorectal cancer screening among a multimorbid rural Appalachian population.
复制标题
DOI：
10.1097/smj.0b013e31823a8879
复制
发表时间：
2011-12
影响因子：
1.1
通讯作者：
Pearce KA
中科院分区：
文献类型：
--
作者：
Fleming ST;Schoenberg NE;Tarasenko YN;Pearce KA
本研究的目的是在肯塔基州阿巴拉契亚地区的老年居民中确定多种疾病与结直肠癌(CRC)筛查患病率之间的关系。这是已知的第一项专门针对健康差异人群的多种疾病的研究。这是一项对来自肯塔基州阿巴拉契亚地区的1153名年龄在50岁到76岁之间的受试者进行的横断面研究。白人种族、高中后教育程度和认为有足够的收入来生存与任何符合指南的结直肠癌筛查的较高比率相关。在调整后的优势比与更多的发病率(P<；0.05)的结肠镜检查结果中，有统计学上的显著趋势；发病率越高，筛查率越高。与许多现有研究相反，在健康差异人群中，我们发现共病与更大的CRC筛查可能性之间存在剂量-反应关系。未来这一领域的研究应该集中在对这一鲜为人知的发现的解释上。此外，这一发现具有重要的临床和行为影响，包括确保在常规办公室访问和外联期间(可能通过社区诊所和公共卫生部门)向无法获得预防保健的极其脆弱的人群提供提供者筛查建议。
The purpose of this study was to determine the relation among multiple morbidities and the prevalence of colorectal cancer (CRC) screening among older adult Appalachian residents of Kentucky. This is the first known study to address multiple morbidities exclusively with a health-disparities population. This was a cross-sectional study of 1153 subjects, aged 50 to 76 years, from Appalachian Kentucky. White race, post–high school education, and perception of having more than enough income on which to survive were associated with higher rates of any guideline concordant CRC screening. Statistically significant trends in the outcome of adjusted odds ratios for colonoscopy with greater number of morbidities (P < 0.05) were noted; the higher number of morbidities, the higher rates of screening. Contrary to much existing research, within a health-disparities population, we found a dose-response relation between comorbidities and greater likelihood of CRC screening. Future research in this area should focus on explanations for this seldom-described finding. In addition, this finding has meaningful clinical and behavioral implications, including ensuring provider screening recommendation during routine office visits and outreach, perhaps through community clinics and public health departments, to extremely vulnerable populations lacking access to preventive care.