自2021年USPSTF推以来,未满足的社会需求和45-49岁的结直肠癌检测自2021年USPSTF推以来
Katherine L Chen1, Carol M Mangione1,2, Ya-Chen Tina Shih1,2,3
1Division of General Internal Medicine & Health Services Research, David Geffen School of Medicine, University of California, Los Angeles (UCLA), Los Angeles, CA, USA.
Journal of the National Cancer Institute
|November 9, 2025
概括
结肠直肠癌 (CRC) 查吸收率在调整后在45-49岁的成年人中没有因社会需求而有所不同. 运输不安全与查者中使用结肠镜的比例较低有关.
科学领域:
- 公共卫生 公共卫生
- 预防医学 预防医学
- 健康差异 在健康上的差异
背景情况:
- 美国预防服务特别工作组 (USPSTF) 在2021年更新了指导方针,建议在平均风险人群中从45岁开始对结肠直肠癌 (CRC) 进行查.
- 年轻成年人 (45-49岁) 的查吸收率仍然很低,对影响这种行为的社会决定因素的理解有限.
- 这项研究研究了未满足的社会需求和CRC查在这个新符合条件的队列之间的关系.
研究的目的:
- 检查未满足的社会需求 (住房,交通,粮食不安全) 与45-49岁成年人中CRC检测的普及之间的联系.
- 评估社会需求对选择CRC查方式 (便与结肠镜) 的影响.
主要方法:
- 2022年行为风险因素监测系统 (BRFSS) 数据的横截面分析.
- 包括13,251名45-49岁的成年人,评估CRC检测状态和方式.
- 使用加权后勤回归模型,根据社会人口统计学和临床因素进行调整,以分析查吸收和模式的预测因素.
主要成果:
- 总体而言,22.5%的符合条件的成年人启动了CRC查后USPSTF推更新.
- 未经调整的分析显示,粮食不安全和更高的未满足的社会需求与较低的查吸收之间存在关联.
- 调整后的模型显示,根据社会需要状况,CRC测试的采用没有显著差异.
- 在接受查的人群中,交通不安全与接受结肠镜检查的可能性降低有关.
结论:
- 经过调整后的分析表明,基于未满足的社会需求,年轻人之间在CRC查启动方面没有显著差异.
- 运输的不安全性可能会影响CRC查方式的选择,有利于更少的侵入性选择.
- 进一步的研究至关重要,以确定在这个人群中进行CRC查的障碍和促进因素,以减少早期CRC负担.
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