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首页> 外文期刊>Preventive Medicine: An International Journal Devoted to Practice and Theory >Factors associated with colorectal cancer screening in a population-based study: the impact of gender, health care source, and time.
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Factors associated with colorectal cancer screening in a population-based study: the impact of gender, health care source, and time.

机译：一项基于人群的研究中与大肠癌筛查相关的因素：性别，医疗保健来源和时间的影响。

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INTRODUCTION: The effectiveness of colorectal cancer screening in reducing incident colorectal cancer and the risk of death has been shown. Despite campaigns to promote the benefits of and use of colorectal cancer screening, most people are not participating in screening. In this paper, we examine factors associated with screening behavior over time, by health care provider, and by gender and report associations between screening and development of colorectal cancer after adjusting for diet and lifestyle factors. METHODS: Data from two population-based case-control studies of colorectal cancer were used to examine risk associations with nonparticipation in colorectal cancer screening. Study participants were identified for the first study between 1991 and 1994 (N = 1,346 cases and 1,544 controls) and for the second between 1997 and 2001 (N = 952 cases and 1,205 controls) and were asked to complete a detailed in-person interviewer-administered diet and lifestyle questionnaire. The control population is used to examine changes in screening behavior and associations with screening over time. RESULTS: Significantly, fewer people reported fecal occult blood test (FOBT) in 1997-2001 than in 1991-1994 (62.5% in 1991-1994 vs. 47.2% in 1997-2001); a slight nonsignificant increase in sigmoidoscopy screening was reported for these periods among controls (33.9% vs. 36.6%). In the control population, during these periods, there was a statistically significant increase in the number of people who reported having had a sigmoidoscopy for screening rather than for problems (72.6% in 1997-2001 vs. 63.8% in 1991-1994). There were differences in factors associated with screening behavior by time, by sex, and by health care provider, although having a family history of colorectal cancer, having more education, and being male was associated with more screening in all settings. After adjusting for diet and lifestyle factors, we observed that non-sigmoidoscopy screening significantly influenced risk of incident cancer (rectal OR:2.9; 95% CI, 2.3-3.7; distal tumor OR: 1.8; 95% CI, 1.4-2.3); proximal tumor: 1.4; 95% CI, 1.1-1.8). Nonuse of FOBT also was associated significantly with tumors in the rectal (OR: 1.6; 95% CI, 1.3-1.9) and distal (OR: 1.4; 95% CI, 1.1-1.8) sites. SUMMARY: These data reinforce the importance of screening to reduce risk of colorectal cancer development. However, flexible sigmoidoscopy screening is increasing only modestly over time, and primarily in settings where a significant investment in screening has been made. FOBT screening, which is effective for rectal cancer prevention, is actually decreasing.
机译：引言：已经证明了大肠癌筛查在减少大肠癌发病率和死亡风险方面的有效性。尽管开展了宣传结肠直肠癌筛查的益处和用途的运动，但大多数人并未参加筛查。在本文中，我们研究了按时间，按医疗保健提供者和按性别分类与筛查行为相关的因素，并在调整饮食和生活方式因素后报告了筛查与大肠癌发展之间的关联。方法：从两项基于人群的大肠癌病例对照研究中获得的数据用于检查与未参与大肠癌筛查的风险关联。确定了研究参与者的1991年至1994年的第一项研究（N = 1,346例病例和1,544名对照），以及第二项研究的1997年至2001年（N = 952例病例和1,205名对照），并被要求完成详细的面试官-管理饮食和生活方式问卷。对照人群用于检查筛查行为的变化以及筛查随时间的变化。结果：与1991-1994年相比，1997-2001年报告粪便潜血测试的人较少（1991-1994年为62.5％，1997-2001年为47.2％）;据报道，在这些时期，对照组的乙状结肠镜检查筛检略有增加（33.9％比36.6％）。在这些时期的对照人群中，据报告接受乙状结肠镜检查而不是进行问题筛查的人数有统计学上的显着增加（1997-2001年为72.6％，1991-1994年为63.8％）。尽管具有结直肠癌的家族病史，受过更多教育，而且在所有情况下男性都与更多筛查相关，但按时间，性别和医护人员的筛查行为相关的因素仍存在差异。在调整饮食和生活方式因素后，我们观察到非乙状结肠镜筛查显着影响了发生癌症的风险（直肠癌OR：2.9; 95％CI，2.3-3.7;远端肿瘤OR：1.8; 95％CI，1.4-2.3）;近端肿瘤：1.4; 95％CI，1.1-1.8）。不使用FOBT还与直肠（OR：1.6; 95％CI，1.3-1.9）和远端（OR：1.4; 95％CI，1.1-1.8）部位的肿瘤显着相关。摘要：这些数据加强了筛查降低结直肠癌发展风险的重要性。然而，随着时间的流逝，灵活的乙状结肠镜筛查仅在适度增加，并且主要是在已经对筛查进行大量投资的环境中。对于预防直肠癌有效的FOBT筛查实际上正在减少。

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