亚裔美国人对大肠癌(CRC)筛查的依从性很高,但尚未得到很好的理解。这项研究调查了菲律宾人筛查意图的相关性,苗族,和不遵守CRC筛查的韩裔美国人。
使用横截面,来自504名亚裔美国人的干预前调查数据(115名菲律宾人,185苗族,和204名韩国人)年龄在50-75岁之间,他们参加了非专业健康教育者干预的多中心集群随机对照试验,我们分析了自我报告的CRC筛查不依从性的相关性,这被定义为不是最新的粪便潜血测试,乙状结肠镜检查,或结肠镜检查。
只有26.8%的参与者表示打算在6个月内进行筛查(苗族:12.4%;韩语:30.8%;菲律宾语:42.6%;P<.001)。只有三分之一的参与者接受过筛查,大多数人不知道筛查是CRC预防方法的一种方法(61.3%)或对CRC筛查指南有任何了解(53.4%).多变量分析显示,患者与提供者的种族一致性,提供者的筛选建议,参与者事先进行CRC筛查,感知CRC的严重程度和易感性,和指南知识与筛查意图呈正相关。具体来说,知道一个或多个筛查指南会使筛查意图的几率加倍(调整后的优势比,2.38;95%置信区间,1.32-4.28)。苗族比菲律宾人不太可能有筛查意图,这是社会人口统计学无法解释的,医疗保健因素,感知到的CRC筛查需求,或筛查指南的知识。
不依从的菲律宾人的CRC筛查意图,苗族,韩裔美国人很低。针对CRC筛查指南的知识可能是提高非依从亚裔美国人CRC筛查意图的有效策略。癌症2018;124:1560-7。©2018美国癌症协会。
Nonadherence to colorectal cancer (CRC) screening among Asian Americans is high but not well understood. This study examined correlates of screening intention among Filipino, Hmong, and Korean Americans who were nonadherent to CRC screening.
Using cross-sectional, preintervention survey data from 504 Asian Americans (115 Filipinos, 185 Hmong, and 204 Koreans) aged 50-75 years who were enrolled in a multisite cluster randomized controlled trial of lay health educator intervention, we analyzed correlates of self-reported CRC screening nonadherence, which was defined as not being up-to-date for fecal occult blood test, sigmoidoscopy, or colonoscopy.
Only 26.8% of participants indicated intention to obtain screening within 6 months (Hmong: 12.4%; Korean: 30.8%; and Filipino: 42.6%; P < .001). Only one third of participants had undergone a prior screening, and a majority did not know that screening is a method of CRC prevention method (61.3%) or had any knowledge of CRC screening
guidelines (53.4%). Multivariable analyses revealed that patient-provider ethnicity concordance, provider\'s recommendation of screening, participants\' prior CRC screening, perceived severity and susceptibility of CRC, and knowledge of
guidelines were positively associated with screening intention. Specifically, knowing one or more screening
guidelines doubled the odds of screening intention (adjusted odds ratio, 2.38; 95% confidence interval, 1.32-4.28). Hmong were less likely to have screening intention than Filipinos, which was unexplained by socio-demographics, health care factors, perceived needs for CRC screening, or knowledge of screening
guidelines.
CRC screening intention among nonadherent Filipino, Hmong, and Korean Americans was low. Targeting knowledge of CRC screening
guidelines may be effective strategies for increasing CRC screening intention among nonadherent Asian Americans. Cancer 2018;124:1560-7. © 2018 American Cancer Society.