目的:计算机断层扫描结肠成像(CTC)是一种用于结直肠癌(CRC)的非侵入性筛查测试,具有高灵敏度和低并发症风险。我们使用了具有全国代表性的合格成人筛查样本,以检查与CTC使用相关的趋势和因素。
方法:我们在2010年,2015年,2018年,2019年和2021年的国家健康访谈调查中检查了58,058名成年人的CTC使用情况。对于每个调查年,我们通过社会人口统计学和健康因素估计了CTC的使用。我们使用多变量逻辑回归来确定与CTC使用相关的因素。
结果:在所有调查年度中,共有1.7%的成年人报告接受了CTC。2010年CTC的使用情况相似(1.3%),2015年(0.8%),2018年(1.4%),2019年(1.4%),但2021年增长(3.5%,p<0.05)。在多变量分析中,2021年调查[与2010年,优势比(OR)2.51,95%置信区间(CI)1.83-3.43],西班牙裔(OR1.73,95%CI1.34-2.23),非西班牙裔黑人(OR2.07,95%CI1.67-2.57),和家庭收入<200%联邦贫困水平(与>400%,OR1.25,95%CI1.01-1.57)与CTC使用相关。Further,有糖尿病史的成年人(OR1.20,95%CI1.01-1.45),慢性阻塞性肺疾病(OR1.58,95%CI1.25-1.99),癌症(OR1.29,95%CI1.05-1.58),或过去一年住院患者(OR1.44,95%CI1.18-1.78)更有可能接受CTC.
结论:CTC的使用从2010年到2019年保持较低,但在2021年有所增加。在患有慢性健康状况的成年人中,使用CTC更为频繁,少数民族,和收入较低的成年人,并可能有助于减少CRC筛查的差异。
OBJECTIVE: Computed tomographic colonography (CTC) is a non-invasive screening test for colorectal cancer (CRC) with high sensitivity and low risk of complications. We used a nationally representative sample of screening-eligible adults to examine trends in and factors associated with CTC use.
METHODS: We examined CTC use among 58,058 adults in the National Health Interview Survey in 2010, 2015, 2018, 2019, and 2021. For each survey year, we estimated CTC use by sociodemographic and health factors. We used multivariable logistic regression to identify factors associated with CTC use.
RESULTS: A total of 1.7 % adults reported receiving CTC across all survey years. CTC use was similar in 2010 (1.3 %), 2015 (0.8 %), 2018 (1.4 %), and 2019 (1.4 %) but increased in 2021 (3.5 %, p < 0.05). In multivariable analysis, survey year 2021 [vs. 2010, odds ratio (OR) 2.51, 95 % confidence interval (CI) 1.83-3.43], Hispanic (OR 1.73, 95 % CI 1.34-2.23), non-Hispanic Black (OR 2.07, 95 % CI 1.67-2.57), and household income <200 % federal poverty level (vs. >400 %, OR 1.25, 95 % CI 1.01-1.57) was associated with CTC use. Further, adults with a history of diabetes (OR 1.20, 95 % CI 1.01-1.45), chronic obstructive pulmonary disease (OR 1.58, 95 % CI 1.25-1.99), cancer (OR 1.29, 95 % CI 1.05-1.58), or past-year hospital admissions (OR 1.44, 95 % CI 1.18-1.78) were more likely to receive CTC.
CONCLUSIONS: CTC use remained low from 2010 to 2019 but increased in 2021. CTC use was more frequent among adults with chronic health conditions, minorities, and adults with lower income, and may help reduce disparities in CRC screening.