Progress in cancer screening practices in the United States - Results from the 2000 National Health Interview Survey
Progress in cancer screening practices in the United States - Results from the 2000 National Health Interview Survey
复制标题
作者：
Swan, J;Breen, N;Lee, NC
背景了解2000年人口群体之间癌症筛查的差异以及随着时间的推移减少群体之间差异的成功或失败对于规划公共卫生战略以减少或消除健康差异至关重要，这是2010年健康人国家癌症筛查目标的主要目标。2000年，新的癌症控制模块添加到国民健康访谈调查（NHIS）收集了更详细的信息，癌症筛查相比，以前的调查。对2000年NHIS和早期调查的数据进行了分析，以辨别癌症筛查实践的模式和趋势，包括巴氏试验、乳房X光检查、前列腺特异性抗原（PSA）筛查和结直肠筛查。这些数据是根据一些人口统计学和社会经济学特征定义的人口亚组报告的。在过去2年内最不可能进行乳房X光检查的女性是那些没有常规医疗保健来源的女性（61%），没有健康保险的女性（67%）以及在过去10年内移民到美国的女性（61%）。过去3年内的巴氏试验结果相似。在男性和女性中，那些在推荐的筛查间隔内最不可能进行粪便潜血试验或内窥镜检查的人没有通常的护理来源（男性14%，女性18%），没有健康保险（男性20%，女性18%），或者是最近的移民（男性20%，女性18%）。自1987年调查以来，对测试使用变化的分析表明，在没有常规护理来源的群体中，差异正在扩大。在最需要帮助的群体中，没有观察到明显的改善。虽然自1987年以来，大多数群体的筛查使用有所增加，但仍然存在重大差异。一些群体，特别是没有通常护理来源的个人和没有保险的人，正在进一步落后;根据2000年的数据，最近的移民在筛查利用方面也有很大的差距。如果要实现癌症筛查的人口效益，就需要更多地关注克服这些群体的筛查障碍。
BACKGROUND. Understanding differences in cancer screening among population groups in 2000 and successes or failures in reducing disparities over time among groups is important for planning a public health strategy to reduce or eliminate health disparities, a major goal of Healthy People 2010 national cancer screening objectives. In 2000, the new cancer control module added to the National Health Interview Survey (NHIS) collected more detailed information on cancer screening compared with previous surveys.METHODS. Data from the 2000 NHIS and earlier surveys were analyzed to discern patterns and trends in cancer screening practices, including Pap tests, mammography, prostate specific antigen (PSA) screening, and colorectal screening. The data are reported for population subgroups that were defined by a number of demographic and socioeconomic characteristics.RESULTS. Women who were least likely to have had a mammogram within the last 2 years were those with no usual source of health care (61%), women with no health insurance (67%), and women who immigrated to the United States within the last 10 years (61%). Results for Pap tests within the last 3 years were similar. Among both men and women, those least likely to have had a fecal occult blood test or endoscopy within the recommended screening interval had no usual source of care (14% for men and 18% for women), no health insurance (20% for men and 18% for women), or were recent immigrants (20% for men and 18% for women). An analysis of changes in test use since the 1987 survey indicates that the disparities are widening among groups with no usual source of care.CONCLUSIONS. No striking improvements have been observed for the groups with greatest need. Although screening use for most groups has increased since 1987, major disparities remain. Some groups, notably individuals with no usual source of care and the uninsured are falling further behind; and, according to the 2000 data, recent immigrants also experience a significant gap in screening utilization. More attention is needed to overcome screening barriers for these groups if the population benefits of cancer screening are to be achieved.