{"title":"美国低收入退伍军人终生接受结直肠癌筛查的比例及相关因素。","authors":"Hind A Beydoun, Jack Tsai","doi":"10.1007/s10552-024-01881-5","DOIUrl":null,"url":null,"abstract":"<p><strong>Purpose: </strong>The Veterans Health Administration (VHA) is the largest integrated healthcare system in the U.S. While preventive healthcare services are high priority in the VHA, low-income U.S. Veterans experience adverse life circumstances that may negatively impact their access to these services. This study examined lifetime prevalence as well as demographic, socioeconomic, military-specific, and clinical correlates of colorectal cancer (CRC) screening among low-income U.S. Veterans ≥ 50 years of age.</p><p><strong>Methods: </strong>Cross-sectional data on 862 participants were analyzed from the 2021-2022 National Veteran Homeless and Other Poverty Experiences study.</p><p><strong>Results: </strong>Overall, 55.3% (95% confidence interval [CI] 51.3-59.3%) reported ever-receiving CRC-screening services. In a multivariable logistic regression model, never-receivers of CRC screening were twice as likely to reside outside of the Northeast, and more likely to be married (odds ratio [OR] = 1.86, 95% CI 1.02, 3.37), have BMI < 25 kg/m<sup>2</sup> [vs. 25- < 30 kg/m<sup>2</sup>] (OR = 1.75, 95% CI 1.19, 2.58), or ≥ 1 chronic condition (OR = 1.46, 95% CI 1.06, 2.02). Never-receivers of CRC screening were less likely to be female (OR = 0.53, 95% CI 0.29, 0.96), aged 65-79y [vs. ≥ 80y] (OR = 0.61, 95% CI 0.40, 0.92), live in 5 + member households (OR = 0.33, 95% CI 0.13, 0.86), disabled (OR = 0.45, 0.22, 0.92), with purchased health insurance (OR = 0.56, 95% CI 0.33, 0.98), or report alcohol-use disorder (OR = 0.10, 95% CI 0.02, 0.49) and/or HIV/AIDS (OR = 0.28, 95% CI 0.12, 0.68).</p><p><strong>Conclusion: </strong>Nearly 55% of low-income U.S. Veterans reported ever screening for CRC. Variations in CRC-screening behaviors according to veteran characteristics highlight potential disparities as well as opportunities for targeted behavioral interventions.</p>","PeriodicalId":9432,"journal":{"name":"Cancer Causes & Control","volume":" ","pages":"1215-1231"},"PeriodicalIF":2.2000,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Lifetime prevalence and correlates of colorectal cancer screening among low-income U.S. Veterans.\",\"authors\":\"Hind A Beydoun, Jack Tsai\",\"doi\":\"10.1007/s10552-024-01881-5\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Purpose: </strong>The Veterans Health Administration (VHA) is the largest integrated healthcare system in the U.S. While preventive healthcare services are high priority in the VHA, low-income U.S. Veterans experience adverse life circumstances that may negatively impact their access to these services. This study examined lifetime prevalence as well as demographic, socioeconomic, military-specific, and clinical correlates of colorectal cancer (CRC) screening among low-income U.S. Veterans ≥ 50 years of age.</p><p><strong>Methods: </strong>Cross-sectional data on 862 participants were analyzed from the 2021-2022 National Veteran Homeless and Other Poverty Experiences study.</p><p><strong>Results: </strong>Overall, 55.3% (95% confidence interval [CI] 51.3-59.3%) reported ever-receiving CRC-screening services. In a multivariable logistic regression model, never-receivers of CRC screening were twice as likely to reside outside of the Northeast, and more likely to be married (odds ratio [OR] = 1.86, 95% CI 1.02, 3.37), have BMI < 25 kg/m<sup>2</sup> [vs. 25- < 30 kg/m<sup>2</sup>] (OR = 1.75, 95% CI 1.19, 2.58), or ≥ 1 chronic condition (OR = 1.46, 95% CI 1.06, 2.02). Never-receivers of CRC screening were less likely to be female (OR = 0.53, 95% CI 0.29, 0.96), aged 65-79y [vs. ≥ 80y] (OR = 0.61, 95% CI 0.40, 0.92), live in 5 + member households (OR = 0.33, 95% CI 0.13, 0.86), disabled (OR = 0.45, 0.22, 0.92), with purchased health insurance (OR = 0.56, 95% CI 0.33, 0.98), or report alcohol-use disorder (OR = 0.10, 95% CI 0.02, 0.49) and/or HIV/AIDS (OR = 0.28, 95% CI 0.12, 0.68).</p><p><strong>Conclusion: </strong>Nearly 55% of low-income U.S. Veterans reported ever screening for CRC. Variations in CRC-screening behaviors according to veteran characteristics highlight potential disparities as well as opportunities for targeted behavioral interventions.</p>\",\"PeriodicalId\":9432,\"journal\":{\"name\":\"Cancer Causes & Control\",\"volume\":\" \",\"pages\":\"1215-1231\"},\"PeriodicalIF\":2.2000,\"publicationDate\":\"2024-09-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Cancer Causes & Control\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1007/s10552-024-01881-5\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2024/5/7 0:00:00\",\"PubModel\":\"Epub\",\"JCR\":\"Q3\",\"JCRName\":\"ONCOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Cancer Causes & Control","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1007/s10552-024-01881-5","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2024/5/7 0:00:00","PubModel":"Epub","JCR":"Q3","JCRName":"ONCOLOGY","Score":null,"Total":0}
引用次数: 0
摘要
目的：退伍军人健康管理局（VHA）是美国最大的综合医疗保健系统。虽然预防性医疗保健服务是退伍军人健康管理局的重中之重，但美国低收入退伍军人所处的不利生活环境可能会对他们获得这些服务产生负面影响。本研究调查了年龄≥ 50 岁的美国低收入退伍军人一生中接受结直肠癌（CRC）筛查的流行率以及人口、社会经济、军事特异性和临床相关因素：方法：分析了 2021-2022 年全国退伍军人无家可归和其他贫困经历研究中 862 名参与者的横截面数据：总体而言，55.3%（95% 置信区间 [CI] 51.3-59.3%）的参与者表示曾经接受过 CRC 筛查服务。在多变量逻辑回归模型中，从未接受过 CRC 筛查的人居住在东北部以外地区的可能性是其他地区的两倍，并且更有可能已婚（比值比 [OR] = 1.86，95% CI 1.02，3.37）、BMI 为 2 [vs. 25- 2] （OR = 1.75，95% CI 1.19，2.58）或≥ 1 种慢性疾病（OR = 1.46，95% CI 1.06，2.02）。从未接受过 CRC 筛查的人群中，女性（OR = 0.53，95% CI 0.29，0.96）、65-79 岁[vs. ≥ 80 岁]（OR = 0.61，95% CI 0.40，0.92）、生活在 5 + 成员家庭（OR = 0.33，95% CI 0.13，0.86）、残疾（OR = 0.33，95% CI 0.29，0.96）、有慢性疾病（OR = 1.46，95% CI 1.06，2.02）或≥ 1 种慢性疾病（OR = 1.46，95% CI 1.06，2.02）的可能性较低。86）、残疾（OR = 0.45，0.22，0.92）、购买了医疗保险（OR = 0.56，95% CI 0.33，0.98）、或报告有酒精使用障碍（OR = 0.10，95% CI 0.02，0.49）和/或艾滋病毒/艾滋病（OR = 0.28，95% CI 0.12，0.68）：结论：近 55% 的低收入美国退伍军人表示曾进行过 CRC 筛查。根据退伍军人的特征，他们的 CRC 筛查行为存在差异，这凸显了潜在的差异，也为有针对性的行为干预提供了机会。
Lifetime prevalence and correlates of colorectal cancer screening among low-income U.S. Veterans.
Purpose: The Veterans Health Administration (VHA) is the largest integrated healthcare system in the U.S. While preventive healthcare services are high priority in the VHA, low-income U.S. Veterans experience adverse life circumstances that may negatively impact their access to these services. This study examined lifetime prevalence as well as demographic, socioeconomic, military-specific, and clinical correlates of colorectal cancer (CRC) screening among low-income U.S. Veterans ≥ 50 years of age.
Methods: Cross-sectional data on 862 participants were analyzed from the 2021-2022 National Veteran Homeless and Other Poverty Experiences study.
Results: Overall, 55.3% (95% confidence interval [CI] 51.3-59.3%) reported ever-receiving CRC-screening services. In a multivariable logistic regression model, never-receivers of CRC screening were twice as likely to reside outside of the Northeast, and more likely to be married (odds ratio [OR] = 1.86, 95% CI 1.02, 3.37), have BMI < 25 kg/m2 [vs. 25- < 30 kg/m2] (OR = 1.75, 95% CI 1.19, 2.58), or ≥ 1 chronic condition (OR = 1.46, 95% CI 1.06, 2.02). Never-receivers of CRC screening were less likely to be female (OR = 0.53, 95% CI 0.29, 0.96), aged 65-79y [vs. ≥ 80y] (OR = 0.61, 95% CI 0.40, 0.92), live in 5 + member households (OR = 0.33, 95% CI 0.13, 0.86), disabled (OR = 0.45, 0.22, 0.92), with purchased health insurance (OR = 0.56, 95% CI 0.33, 0.98), or report alcohol-use disorder (OR = 0.10, 95% CI 0.02, 0.49) and/or HIV/AIDS (OR = 0.28, 95% CI 0.12, 0.68).
Conclusion: Nearly 55% of low-income U.S. Veterans reported ever screening for CRC. Variations in CRC-screening behaviors according to veteran characteristics highlight potential disparities as well as opportunities for targeted behavioral interventions.
期刊介绍：
Cancer Causes & Control is an international refereed journal that both reports and stimulates new avenues of investigation into the causes, control, and subsequent prevention of cancer. By drawing together related information published currently in a diverse range of biological and medical journals, it has a multidisciplinary and multinational approach.
The scope of the journal includes: variation in cancer distribution within and between populations; factors associated with cancer risk; preventive and therapeutic interventions on a population scale; economic, demographic, and health-policy implications of cancer; and related methodological issues.
The emphasis is on speed of publication. The journal will normally publish within 30 to 60 days of acceptance of manuscripts.
Cancer Causes & Control publishes Original Articles, Reviews, Commentaries, Opinions, Short Communications and Letters to the Editor which will have direct relevance to researchers and practitioners working in epidemiology, medical statistics, cancer biology, health education, medical economics and related fields. The journal also contains significant information for government agencies concerned with cancer research, control and policy.
求助内容：
应助结果提醒方式：
京公网安备 11010802042870号
