摘要/ Abstract摘要/ Abstract A051:近期确诊结肠癌人群对结直肠癌筛查检测认知的种族和性别差异

L. Carnahan, Lindsey A. Jones, Katherine C. Brewer, Y. Molina, G. Rauscher
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引用次数: 0

摘要

背景:与非西班牙裔白人(NHW)相比,非西班牙裔黑人(NHB)人群接受指南一致性结直肠癌(CRC)筛查的可能性较小。结直肠癌筛查障碍是多方面的,包括卫生保健的获取和利用、社会人口学特征、个人对癌症的信念和认识、筛查测试和指南等因素。无法回忆或识别结直肠癌检查以及对筛查指南的了解不足可能导致整个结肠癌连续体的不同结果。目的:在本研究中,我们试图1)描述城市结肠癌患者对筛查试验和指南的认知度,以及2)检查对指南的认知度和知识是否与癌症检测方式(筛查检测与症状表现)相关。方法:芝加哥结肠癌治疗模式研究是一项描述性横断面研究,研究了CRC筛查、治疗开始、诊断阶段和后续治疗方面的种族、性别和社会经济地位差异。符合条件的患者是NHB和NHW,年龄45-79岁,患有原发性侵袭性结肠癌,来自9个不同的城市卫生保健机构。在同意后,参与者完成了一次面对面的访谈,其中他们回答了有关结肠癌粪便的回忆和识别、乙状结肠镜检查和结肠镜筛查测试以及筛查指南、诊断途径和治疗、社会人口统计学特征和卫生保健获取和利用方面的知识的问题。他们完成访谈并同意提取医疗记录,可获得100美元。使用Logistic回归对知识和意识变量与结肠癌检测方式(症状与筛查检测)之间的关联进行建模。合并非响应权重,以解释不同设施、年龄、种族和性别和模型的回复率差异,并在所有模型中控制年龄、种族、性别和综合SES变量。结果:大便检查和乙状结肠镜检查的召回率较低(分别为13%和5%);这些测试的名字识别率分别为59%和30%。正确的指南知识在所有三项检查中都很低(乙状结肠镜检查为7%,FOBT检查为14%,结肠镜检查为19%)。NHB患者和社会经济弱势患者的回忆、认知和知识水平较低。与回忆至少一个测试相比,不能说出或回忆单个测试与屏幕检测减少相关(36%对22%,p=0.01)。讨论:我们的结果应该有助于确定需要加强教育的目标人群,并由他们的卫生保健提供者提供额外的提示,以确保他们获得必要的结肠癌长期监测。引文格式:Leslie R. Carnahan, Lindsey Jones, Katherine Brewer, Yamile Molina, Garth Rauscher。新近确诊结肠癌人群对结直肠癌筛查试验认知的种族和性别差异[摘要]。见:第十一届AACR会议论文集:种族/少数民族和医疗服务不足人群的癌症健康差异科学;2018年11月2-5日;新奥尔良,洛杉矶。费城(PA): AACR;癌症流行病学杂志,2020;29(6增刊):摘要nr A051。
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Abstract A051: Race and gender differences in awareness of colorectal cancer screening tests among recently diagnosed colon cancer
Background: Non-Hispanic Black (NHB) populations, compared to non-Hispanic Whites (NHW), are less likely to receive guideline concordant colorectal cancer (CRC) screening. CRC screening barriers are multifaceted and involve factors including health care access and utilization, sociodemographic characteristics, and individuals9 beliefs and awareness about cancer, screening tests, and guidelines. Inability to recall or recognize CRC tests and low knowledge of screening guidelines may contribute to disparate outcomes across the colon cancer continuum. Objective: In the present study, we sought to 1) characterize the prevalence of urban colon cancer patients9 awareness of screening tests and guidelines, and 2) examine if awareness and knowledge of guidelines were associated with mode of cancer detection (screen-detected versus symptomatic presentation). Methods: The Colon Cancer Patterns of Care in Chicago study was a descriptive cross-sectional study that examined racial, gender, and SES disparities in CRC screening, care initiation, diagnostic stage, and subsequent treatment. Eligible patients were NHB and NHW, aged 45-79, with first primary invasive colon cancer, and were recruited from nine diverse, urban health care institutions. After consent, participants completed an in-person interview wherein they responded to questions related to the recall and recognition of colon cancer stool, sigmoidoscopy, and colonoscopy screening tests and knowledge of screening guidelines, diagnostic pathways and treatment, sociodemographic characteristics, and health care access and utilization. They received $100 for completing the interview and consenting to medical record abstraction. Logistic regression was used to model the association between knowledge and awareness variables and colon cancer mode of detection (symptomatic versus screen detection). incorporating nonresponse weights created to account for differences in response rate by facility, age, race and gender, and models were, and controlling for age, race, gender and the composite SES variable in all models. Results: Recall of stool testing and sigmoidoscopy was low (13% and 5%); name recognition of these tests was 59% and 30%, respectively. Correct guideline knowledge was low for all three tests (7% for sigmoidoscopy, 14% for FOBT, and 19% for colonoscopy). Recall, recognition, and knowledge were lower for NHB and socioeconomically disadvantaged patients. Inability to name or recall a single test was associated with reduced screen-detection compared with recall of at least one test (36% vs. 22%, p=0.01). Discussion: Our results should help to identify target populations in need of enhanced education and additional prompting by their health care providers to ensure that they obtain the necessary surveillance for colon cancer over the long term. Citation Format: Leslie R. Carnahan, Lindsey Jones, Katherine Brewer, Yamile Molina, Garth Rauscher. Race and gender differences in awareness of colorectal cancer screening tests among recently diagnosed colon cancer [abstract]. In: Proceedings of the Eleventh AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2018 Nov 2-5; New Orleans, LA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2020;29(6 Suppl):Abstract nr A051.
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