在物质使用障碍患者中进行结肠直肠癌查:一项回顾性队列研究
Kento Sonoda1, Joanne Sales1,2, Jennifer K Bello1
1Department of Family and Community Medicine, Saint Louis University School of Medicine, St. Louis, Missouri.
AJPM focus
|April 10, 2024
概括
患有物质使用障碍 (SUD) 的人不太可能完成结直肠癌查. 通过多学科团队解决障碍,可以减少这种健康差异.
科学领域:
- 在瘤学瘤学.
- 公共卫生 公共卫生
- 医疗保健服务研究 医疗服务研究
背景情况:
- 有限证据表明,在有史以来使用物质障碍 (SUD) 的人群中,结肠直肠癌 (CRC) 查完成率有限.
- 癌症查对早期检测和改善结果至关重要,但在某些人群中仍然存在差异.
- 了解像SUD患者这样的弱势群体的查行为对于有针对性的干预至关重要.
研究的目的:
- 调查个人药物使用障碍 (SUD) 史与结肠直肠癌 (CRC) 结肠镜查完成率之间的关联.
- 为了确定SUD诊断和没有SUD诊断的患者之间CRC查吸收的潜在差异.
- 为改善SUD患者CRC查遵守率的策略提供信息.
主要方法:
- 追溯队列研究分析了来自中西部医疗保健系统的176,300名患者 (50-65岁) 的电子健康记录 (2008-2022).
- 在10年的随访期内,对具有 (n=4,327) 和没有 (n=171,973) SUD诊断的患者之间的CRC结肠镜查完成率进行了比较.
- 使用平衡和加权日志双项模型来控制混因素,包括人口统计,并发病症和先前查史.
主要成果:
- 总体而言,40.3%的符合条件的患者完成了CRC结肠镜查.
- 患有SUD诊断的个体完成CRC查的可能性明显低 (未调整的RR=0.73;调整的RR=0.81).
- SUD与较低的查率之间的关联没有受到性别,种族,精神病共同疾病或社会经济地位的改变.
结论:
- 个人药物使用障碍史独立地与较低的结直肠癌查完成率有关.
- 医疗保健专业人员必须认识到并解决SUD患者所面临的独特障碍,以减少CRC查差异.
- 建议在门诊环境中采用多学科的团队方法,以提高这一群体的CRC查遵守率.
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