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首页> 外文期刊>Preventive Medicine: An International Journal Devoted to Practice and Theory >Colorectal cancer screening among Hispanics in the United States: Disparities, modalities, predictors, and regional variation
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Colorectal cancer screening among Hispanics in the United States: Disparities, modalities, predictors, and regional variation

机译：美国西班牙裔美国人的结肠直肠癌筛查：差异，方式，预测因子和区域变异

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Hispanics represent the largest and one of the fastest growing minority populations in the U.S. and have lower survival from colorectal cancer (CRC) than non-Hispanic Whites (NHW). We aimed to examine screening modalities, predictors, and regional disparities among Hispanics and NHW in the U.S. by conducting a cross-sectional analysis of Hispanic participants age 50 to 75 from the 2016 Behavioral Risk Factor Surveillance System (BRFSS) survey. The primary outcome was self-reported CRC screening status. We used the Rao-Scott Chi-square test to compare screening rates and modalities in NHWs and Hispanics. We also used univariable and multivariable logistic regression to determine predictors of screening among Hispanics and calculated Hispanic-NHW screening rate differences for each U.S. state/territory as a measure of regional screening disparities. The screening rate was 53.4% for Hispanics (N = 12,395), compared to 70.4% for NHWs (N = 186,331) (p < 0.001). Among Hispanics, colonoscopy was most common (75.9%). Uninsured status (aOR = 0.51; 95% CI = 0.38-0.70) and limited access to medical care (aOR = 0.38; 95% CI = 0.29-0.49) predicted lack of screening. States/territories with the largest screening disparities were North Carolina (33.9%), Texas (28.3%), California (25.1%), and Nebraska (25.6%). Disparities were smallest in New York (2.6%), Indiana (3.1%), and Delaware (4.0%). In Ohio and Guam, Hispanics had higher screening rates than NHWs. In conclusion, Hispanics have lower CRC screening rates than NHWs across most U.S. states/territories; however, the disparity varies by region. Future efforts must address multi-level barriers to screening among Hispanics and target regions with low rates to improve CRC outcomes in this growing population.
机译：拉美裔是美国人口最多、增长最快的少数民族之一，结直肠癌（CRC）的存活率低于非拉美裔白人（NHW）。我们旨在通过对2016年行为风险因素监测系统（BRFSS）调查中50至75岁的拉美裔参与者进行横断面分析，研究美国拉美裔和NHW的筛查模式、预测因素和地区差异。主要结果是自我报告的CRC筛查状态。我们使用Rao-Scott卡方检验来比较NHW和西班牙裔的筛查率和方式。我们还使用单变量和多变量逻辑回归来确定西班牙裔筛查的预测因素，并计算每个美国州/地区的西班牙裔NHW筛查率差异，作为地区筛查差异的衡量标准。西班牙裔（N=12395）的筛查率为53.4%，而非霍奇金淋巴瘤（N=186331）的筛查率为70.4%（p<0.001）。在西班牙裔中，结肠镜检查最常见（75.9%）。未参保状态（aOR=0.51；95%可信区间=0.38-0.70）和有限的医疗服务（aOR=0.38；95%可信区间=0.29-0.49）预示着筛查的缺乏。筛查差异最大的州/地区是北卡罗来纳州（33.9%）、德克萨斯州（28.3%）、加利福尼亚州（25.1%）和内布拉斯加州（25.6%）。纽约州（2.6%）、印第安纳州（3.1%）和特拉华州（4.0%）的差距最小。在俄亥俄州和关岛，西班牙裔的筛查率高于NHW。总之，在美国大多数州/地区，拉美裔人的CRC筛查率低于NHW；然而，差距因地区而异。未来的努力必须解决西班牙裔和低发病率目标地区筛查的多层次障碍，以改善这一不断增长的人口中的CRC结果。

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