Screening Colonoscopy among Uninsured and Underinsured Urban Minorities
Screening Colonoscopy among Uninsured and Underinsured Urban Minorities
复制标题
DOI：
10.5009/gnl14039
复制
发表时间：
2015-07-01
期刊：
影响因子：
3.4
通讯作者：
Itzkowitz, Steven H.
中科院分区：
文献类型：
--
作者：
Collazo, Tyson H.;Jandorf, Lina;Itzkowitz, Steven H.
背景/目标：没有保险的人结肠镜检查（SC）的筛查率较低，并且对他们接受结肠镜检查时获得的病理结果知之甚少。自2004年以来，我们参加了一个计划，提供SC无保险的纽约人;在这里，我们报告我们的调查结果。方法：2004年4月至2011年6月期间，年龄至少50岁的无保险、平均风险患者在我们的机构接受了SC。我们分析了息肉的病理学、位置、大小、腺瘤的发生率以及与种族、性别和年龄相关的晚期病理学（MP）腺瘤的发生率。结果：在493例转诊患者中，222例患者完成了结肠镜检查。21.2%的患者发现息肉; 14%有腺瘤，4.5%有MR。非裔美国人、西班牙裔美国人和白人中腺瘤的发生率分别为24.3%、12.1%和11.6%，相应的MP发生率分别为10.8%、3.5%和2.3%。息肉类型、位置和MP的差异在种族或性别方面没有达到统计学显著性。发现60岁及以上患者的晚期腺瘤发生率高于年轻患者（8.6% vs 2.6%，p=0.047）。结论：进一步努力为没有保险的个人提供筛查结肠镜检查的资金，可能会导致在结肠进展为结直肠癌之前识别出晚期结肠病变。
Background/Aims: Uninsured individuals have lower rates of screening colonoscopy (SC), and little is known regarding the pathology results obtained when they undergo colonoscopies. Since 2004, we have participated in a program that offers SC to uninsured New Yorkers; herein, we report our findings. Methods: Uninsured, average-risk patients who were at least 50 years of age underwent SC at our institution between April 2004 and June 2011. We analyzed polyp pathology, location, size, incidence of adenomas, and incidence of adenomas with advanced pathology (MP) with respect to ethnicity, gender, and age. Results: Out of 493 referrals, 222 patients completed the colonoscopies. Polyps were identified in 21.2% of all patients; 14% had adenomas, and 4.5% had MR The rates of adenomas among African-Americans, Hispanics, and Whites were 24.3%, 12.1%, and 11.6%, respectively, and the corresponding rates of MP were 10.8%, 3.5%, and 2.3%. Differences in the polyp type, location, and MP did not reach statistical significance with respect to ethnicity or gender. Patients aged 60 and older were found to have a higher rate of advanced adenomas compared with younger patients (8.6% vs 2.6%, p=0.047). Conclusions: Further efforts to fund screening colonoscopies for uninsured individuals will likely result in the identification of advanced lesions of the colon before they progress to colorectal cancer.