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首页> 外文期刊>AIDS care. >Coloreetal cancer incidence and screening in US Medicaid patients with and without HIV infection
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Coloreetal cancer incidence and screening in US Medicaid patients with and without HIV infection

机译：在有和没有HIV感染的美国医疗补助患者中大肠癌的发病率和筛查

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Non-AIDS defining malignancies, particularly coloreetal cancer (CRC), may be more prevalent among persons living with HIV (PLWH). Further, PLWH may be less likely to receive CRC screening (CRCS). We studied the epidemiology of CRC and CRCS patterns in PLWH and HIV-uninfected persons in a large US Medicaid population. We performed a matched cohort study examining CRC incidence in 2006 and CRCS between 1999 and 2007. Study participants were continuously enrolled in the Medicaid programs of California, Florida, New York, Ohio, and Pennsylvania. All PLWH enrollees were matched to five randomly sampled HIV-uninfected enrollees on 5-year age group, gender, and state. Adjusted odds ratios (AORs) for incident CRC (adjusted for comorbidity index) and the presence of CRCS (adjusted for comorbidity index and years in the data-set) among PLWH compared to HIV-uninfected enrollees were calculated. PLWH were not more likely to be diagnosed with CRC after adjusting for comorbidity index (unadjusted OR: 1.73, 95% confidence interval [CI]: 1.37-2.19; AOR 1.29; 95% CI: 0.98-1.70). While CRCS rates were low overall, PLWH were more likely to have received CRCS in unadjusted analyses (35.8% vs. 33.7%; OR 1.10, 95% CI: 1.07-1.13). This relationship was reversed after adjusting for comorbidity index and years in the data-set (AOR: 0.80, 95% CI: 0.77-0.83). Limitations of the study include a focus on the Medicaid population, an inability to detect fecal occult blood tests (FOBT), and having half of patients between 50 and 55 years of age. In conclusion, PLWH were not more likely to be diagnosed with CRC, but in adjusted analyses, were less likely to have received CRCS. As we showed a low rate of CRCS overall in this Medicaid population, researchers, clinicians, and policy-makers should improve access to and uptake of CRCS among all Medicaid patients, and particularly among PLWH.
机译：在艾滋病毒携带者（PLWH）中，非艾滋病毒定义的恶性肿瘤，尤其是结肠直肠癌（CRC）可能更为普遍。此外，PLWH不太可能接受CRC筛查（CRCS）。我们研究了美国大量医疗补助人群中PLWH和HIV感染者中CRC和CRCS模式的流行病学。我们进行了一项队列研究，研究了2006年的CRC发病率以及1999年至2007年的CRCS。研究参与者不断参加了加利福尼亚，佛罗里达，纽约，俄亥俄州和宾夕法尼亚州的医疗补助计划。在5岁年龄组，性别和状态下，所有PLWH入组者均与5名随机抽样的HIV未感染入组者匹配。计算出未感染艾滋病毒的艾滋病病毒感染者的CRC校正后的比值比（AOR）（针对合并症指数进行了校正）和CRCS的存在（针对合并症指数和数据年份进行了校正）。调整合并症指数后，PLWH不太可能被诊断为CRC（未调整OR：1.73，95％置信区间[CI]：1.37-2.19; AOR 1.29; 95％CI：0.98-1.70）。虽然CRCS总体上较低，但在未经调整的分析中，PLWH更有可能接受CRCS（35.8％对33.7％;或1.10，95％CI：1.07-1.13）。在调整数据中的合并症指数和年份后，这种关系发生了逆转（AOR：0.80，95％CI：0.77-0.83）。该研究的局限性包括关注医疗补助人群，无法检测粪便潜血试验（FOBT），并且一半的患者年龄在50至55岁之间。总之，PLWH不太可能被诊断为CRC，但在调整后的分析中，接受CRCS的可能性较小。由于我们在该医疗补助人群中总体CRCS发生率较低，因此研究人员，临床医生和政策制定者应改善所有医疗补助患者（尤其是PLWH患者）对CRCS的获取和摄取。

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