SELF-REPORTED USE OF CANCER SCREENING-TESTS AMONG LATINOS AND ANGLOS IN A PREPAID HEALTH PLAN
SELF-REPORTED USE OF CANCER SCREENING-TESTS AMONG LATINOS AND ANGLOS IN A PREPAID HEALTH PLAN
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DOI：
10.1001/archinte.154.10.1073
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发表时间：
1994-05-23
影响因子：
--
通讯作者：
HIATT, RA
中科院分区：
文献类型：
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作者：
PEREZSTABLE, EJ;OTEROSABOGAL, R;HIATT, RA
目的：为了评估拉丁裔和Angle预付费健康计划成员自我报告的癌症筛查测试的使用情况，我们进行了电话采访，了解巴氏涂片（Pap）涂片、临床乳腺检查、乳房X光检查、直肠检查、粪便潜血试验和乙状结肠镜检查的知识、使用情况和原因。对加州旧金山县和弗朗西斯科县和阿拉米达县随机选择的Kaiser Permanente医疗护理计划成员进行了横断面电话调查。共有844名拉丁美洲人（432名男性和412名女性）和510角（208名男性和302名女性），35和74岁之间，完成了interview.Results：总体而言，97.4%的拉丁美洲人报告有至少一个巴氏涂片与99.7%的角女性相比，90%的每组报告巴氏涂片在3年内。87%的拉丁妇女和90%的盎格鲁妇女报告在2年内进行了临床乳房检查。76%的拉丁裔和85%的35岁以上的盎格鲁女性报告至少有一次乳房X光检查; 65%的拉丁裔和75%的盎格鲁女性报告在2年内进行了乳房X光检查。在40至74岁的成员中，与盎格鲁人相比，拉丁美洲人报告至少有一次直肠指检（67%对80%）和一次粪便潜血试验（46%对54%）的比例较低;在50至74岁的成员中，拉丁美洲人报告至少有一次乙状结肠镜检查（29%对41%）。在对年龄、教育、就业、自觉健康状况、婚姻状况和居住县进行调整后，拉丁美洲人报告至少进行过一次直肠指检的可能性显著降低（比值比; 0.60，95%置信区间，0.45，0.79），粪便潜血试验（比值比，0.77; 95%置信区间，0.59-1.01）和乙状结肠镜检查（比值比，0.70; 95%置信区间，0.52，0.95）。在调整相同的变量后，拉丁美洲人比盎格鲁人更有可能声称健忘/粗心（75%对60%;比值比，1.84; 95%可信区间，1.41-2.40）作为不进行癌症筛查的原因。这些数据表明，在这种预付健康计划中，癌症筛查服务没有直接的财务障碍，拉丁美洲人比盎格鲁人更不可能获得推荐的癌症筛查测试。
Objective: To evaluate self-reported use of cancer screening tests by Latino and Angle prepaid health plan members, we conducted telephone interviews about the knowledge of, use of, and reason for Papanicolaou (Pap) smear, clinical breast examination, mammogram, rectal examination, fecal occult blood test, and sigmoidoscopy.Methods: Cross-sectional telephone survey of randomly selected Kaiser Permanente Medical Care Program members in San Francisco and Alameda Counties, California. A total of 844 Latinos (432 men and 412 women) and 510 Angles (208 men and 302 women), between 35 and 74 years of age, completed the interview.Results: Overall, 97.4% of Latinas reported having had at least one Pap smear compared with 99.7% of Angle women; 90% in each group reported a Pap smear within 3 years. A clinical breast examination within 2 years was reported by 87% of Latina and 90% of Angle women. Seventy-six per cent of Latina and 85% of Angle women aged 35 years or more reported having had at least one mammogram; and 65% of Latina and 75% of Angle women reported a mammogram within 2 years. Among members 40 to 74 years of age, a lower proportion of Latinos compared with Angles reported having had at least one digital rectal examination (67% vs 80%) and one fecal occult blood test (46% vs 54%); among those 50 to 74 years of age, fewer Latinos reported at least one sigmoidoscopy (29% vs 41%). After adjusting for age, education, employment, perceived health status, marital status, and county of residence, Latinos were significantly less likely to report having had at least one digital rectal examination (odds ratio; 0.60, 95% confidence interval, 0.45, 0.79), fecal occult blood test (odds ratio, 0.77; 95% confidence interval, 0.59-1.01), and sigmoidoscopy (odds ratio, 0.70; 95% confidence interval, 0.52, 0.95). After adjusting for the same variables, Latinos were more likely than Angles to claim forgetfulness/carelessness (75% vs 60%; odds ratio, 1.84; 95% confidence interval, 1.41-2.40) as a reason for not obtaining cancer screening tests.Conclusion: These data suggest that, within this prepaid health plan without direct financial barriers to cancer screening services, Latinos are less likely than Angles to obtain selected recommended cancer screening tests.