Colorectal cancer screening among obese versus non-obese patients in primary care practices

被引:85
作者
Ferrante, Jeanne M.
Ohman-Strickland, Pamela
Hudson, Shawna V.
Hahn, Karissa A.
Scott, John G.
Crabtree, Benjamin F.
机构
[1] UMDNJ, Dept Family Med, New Jersey Med Sch, Newark, NJ 07101 USA
[2] UMDNJ, Dept Family Med, Robert Wood Johnson Med Sch, Newark, NJ 07101 USA
[3] UMDNJ, Sch Publ Hlth, Dept Biostat, Newark, NJ 07101 USA
[4] UMDNJ, Sch Publ Hlth, Dept Epidemiol, Newark, NJ 07101 USA
来源
CANCER DETECTION AND PREVENTION | 2006年 / 30卷 / 05期
关键词
colorectal neoplasm; colonoscopy; obesity; primary healthcare; family practice; medical audit; medical records; cancer mortality; comorbidity; barriers; high-risk group; screening disparity; non-obese patients; selection criteria; hypertension; diabetes; body mass index; socioeconomic status;
D O I
10.1016/j.cdp.2006.09.003
中图分类号
R73 [肿瘤学];
学科分类号
100214 [肿瘤学];
摘要
Background: Obesity is associated with increased colorectal cancer incidence and mortality. Previous studies using telephone survey data showed that obese women were less likely to receive colorectal cancer screening. It is unknown if this is true among patients in primary care practices. Methods: Retrospective chart reviews were conducted in 2003-2004 of men and women in 22 suburban New Jersey and Pennsylvania primary care practices. Data from patients age 50 years and over (n = 1297) were analyzed using hierarchical logistic regression. The outcome measure was receipt of colorectal cancer screening (fecal occult blood test within 1 year, sigmoidoscopy within 5 years, colonoscopy within 10 years, or barium enema within 5 years) among obese and non-obese patients. Results: Overall, 39% of patients were obese and 29% received colorectal cancer screening. After controlling for age, gender, total number of co-morbidities, number of visits in the past 2 years, and number of years in the practice, obese patients had 25% decreased odds of being screened for colorectal cancer compared to non-obese patients (OR 0.75, 95% Cl, 0.62-0.91). The relationship of obesity and colorectal cancer screening did not differ according to gender. Number of visits (OR 1.04, 95% Cl, 1.01-1.06) and male gender(OR 1.53, 95% Cl, 1.19-1.97) was associated with increased odds of receiving colorectal cancer screening. Conclusion: Identification of physician and patient barriers to colorectal cancer screening is needed, particularly in obese patients, so that effective interventions may be developed to increase screening in this high-risk group. (c) 2006 International Society for Preventive Oncology. Published by Elsevier Ltd. All rights reserved.
引用
收藏
页码:459 / 465
页数:7
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