Cancer Screening among Rural People Who Use Drugs: Colliding Risks and Barriers.
Cancer Screening among Rural People Who Use Drugs: Colliding Risks and Barriers.
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DOI：
10.3390/ijerph19084555
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发表时间：
2022-04-10
影响因子：
--
通讯作者：
Van Ham, Brent
中科院分区：
文献类型：
--
作者：
Jenkins, Wiley D.;Rose, Jennifer;Molina, Yamile;Lee, Minjee;Bolinski, Rebecca;Luckey, Georgia;Van Ham, Brent
农村癌症差异与较低的医疗保健可及性和筛查依从性有关。阿片类药物的流行可能会增加差距，因为吸毒者（PWUD）经常经历与医疗保健相关的污名化经历，从而阻碍寻求常规护理。招募农村puwud完成癌症（子宫颈癌、乳腺癌、结直肠癌、肺癌）风险、筛查史和医疗保健经历的调查和访谈。从2020年7月至2021年7月，我们收集了37项调查和8次访谈。参与者中男性占24.3%，白人占86.5%，平均年龄为44.8岁。女性不太可能报告定期看初级保健提供者，更有可能报告污名化的医疗保健经历。大多数女性报告接受了宫颈癌和乳腺癌的建议和筛查，但只有少数人坚持接受。同样，只有少数男性和女性报告接受了结直肠癌和肺癌的筛查试验。所有癌症的筛查率大大低于美国的总体水平，特别是农村地区。访谈证实了污名化的医疗保健经历，并提出了筛查障碍和可能的解决方案。阿片类药物流行病涉及数百万人，在农村社区尤为严重。为了避免加剧现有的农村癌症差异，需要开发让PWUD参与癌症筛查的方法。
Rural cancer disparities are associated with lesser healthcare access and screening adherence. The opioid epidemic may increase disparities as people who use drugs (PWUD) frequently experience healthcare-associated stigmatizing experiences which discourage seeking routine care. Rural PWUD were recruited to complete surveys and interviews exploring cancer (cervical, breast, colorectal, lung) risk, screening history, and healthcare experiences. From July 2020–July 2021 we collected 37 surveys and 8 interviews. Participants were 24.3% male, 86.5% White race, and had a mean age of 44.8 years. Females were less likely to report seeing a primary care provider on a regular basis, and more likely to report stigmatizing healthcare experiences. A majority of females reporting receiving recommendations and screens for cervical and breast cancer, but only a minority were adherent. Similarly, only a minority of males and females reported receiving screening tests for colorectal and lung cancer. Screening rates for all cancers were substantially below those for the US generally and rural areas specifically. Interviews confirmed stigmatizing healthcare experiences and suggested screening barriers and possible solutions. The opioid epidemic involves millions of individuals and is disproportionately experienced in rural communities. To avoid exacerbating existing rural cancer disparities, methods to engage PWUD in cancer screening need to be developed.
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