Do physician recommendations for colorectal cancer screening differ by patient age?

被引:17
作者
Sewitch, Maida J.
Fournier, Caroline
Dawes, Martin
Yaffe, Mark
Snell, Linda
Roper, Mark
Zanelli, Patrizia
Pavilanis, Alan
机构
[1] McGill Univ, Ctr Hlth, Res Inst, Dept Clin Epidemiol, Montreal, PQ H3A 1A1, Canada
[2] McGill Univ, Ctr Hlth, Res Inst, Dept Med, Montreal, PQ H3A 1A1, Canada
[3] McGill Univ, Dept Family Med, Montreal, PQ H3A 1A1, Canada
[4] McGill Univ, Div Gen Internal Med, Montreal, PQ H3A 1A1, Canada
[5] McGill Univ, Ctr Med Educ, Montreal, PQ H3A 1A1, Canada
[6] McGill Univ, Div Internal Med, Montreal, PQ H3A 1A1, Canada
[7] McGill Univ, Div Crit Care, Montreal, PQ H3A 1A1, Canada
关键词
ageism; colorectal cancer; disparity; screening;
D O I
10.1155/2007/938978
中图分类号
R57 [消化系及腹部疾病];
学科分类号
摘要
Colorectal cancer screening is underutilized, resulting in preventable morbidity and mortality. In the present study, age-related and other disparities associated with physicians' delivery of colorectal cancer screening recommendations were examined. The present cross-sectional study included 43 physicians and 618 of their patients, aged 50 to 80 years, without past or present colorectal cancer. Of the 285 screen-eligible patients, 45% received a recommendation. Multivariate analyses revealed that, compared with younger nondepressed patients, older depressed patients were less likely to receive fecal occult blood test recommendations, compared with no recommendation (OR=0.31, 95% CI 0.09 to 1.02), as well as less likely to receive cotonoscopy recommendations, compared with no recommendation (OR=0.14; 95% CI 0.03 to 0.66). Comorbidity and marital status were associated with delivery of fecal occult blood test and colonoscopy recommendations, respectively, compared with no recommendation. In summary, patient age and other characteristics appeared to influence physicians' delivery of colorectal cancer screening and choice of modality.
引用
收藏
页码:435 / 438
页数:4
相关论文
共 26 条
[1]  
ALLISON PD, 2001, LOGISTIC REGRESSION, P111
[2]  
*CAN CANC SOC, 2004, SCRREN COL CANC
[3]  
Canadian Task Force on Preventive Health Care, 2001, CMAJ, V165, P206
[4]   Cancer in the elderly: To screen or not to screen? [J].
Capurso, S ;
Gambassi, G ;
Bernabei, R .
JOURNAL OF THE AMERICAN GERIATRICS SOCIETY, 2003, 51 (12) :1816-1816
[5]   Racial disparities in the use of and indications for colorectal procedures in Medicare beneficiaries [J].
Cooper, GS ;
Koroukian, SM .
CANCER, 2004, 100 (02) :418-424
[6]   Depression as a risk factor for cancer: Renewing a debate on the psychobiology of disease [J].
Croyle, RT .
JOURNAL OF THE NATIONAL CANCER INSTITUTE, 1998, 90 (24) :1856-1857
[7]  
Devins GM., 1988, Psychol Health, V2, P139, DOI DOI 10.1080/08870448808400349
[8]   In re colon cancer screening [J].
Friedel, D .
JOURNAL OF THE AMERICAN GERIATRICS SOCIETY, 2001, 49 (01) :97-97
[9]   Racial and ethnic disparities in cancer screening - The importance of foreign birth as a barrier to care [J].
Goel, MS ;
Wee, CC ;
McCarthy, EP ;
Davis, RB ;
Ngo-Metzger, Q ;
Phillips, RS .
JOURNAL OF GENERAL INTERNAL MEDICINE, 2003, 18 (12) :1028-1035
[10]   Associations of race, education, and patterns of preventive service use with stage of cancer at time of diagnosis [J].
Gornick, ME ;
Eggers, PW ;
Riley, GF .
HEALTH SERVICES RESEARCH, 2004, 39 (05) :1403-1427