バイタルサイン：大腸癌スクリーニング検査の利用 ― アメリカ、2018年

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ホーム IMICライブラリ MMWR抄訳 2020年（Vol.69)バイタルサイン：大腸癌スクリーニング検査の利用 ―･･･

MMWR抄訳

2020/03/13Vol. 69 / No. 10

MMWR69(10):253－259
Vital Signs: Colorectal Cancer Screening Test Use — United States, 2018

バイタルサイン：大腸癌スクリーニング検査の利用 ― アメリカ、2018年

2018年のBehavioral Risk Factor Surveillance Systemの調査データから、アメリカの50～75歳の成人における大腸癌(CRC)のスクリーニング検査率が分析された。2018年における検査率は68.8％で、年齢別では50～54歳にてもっとも低く(50.0％)、年齢とともに有意に増加し(p＜0.005)、70～75歳では81.3％であり、全体を50～64歳と65～75歳に分けた場合、それぞれ63.3％、79.2％であった。50～64歳では女性(65.4％、男性61.1％)、医療保険加入者(66.7％、未加入者32.6％)、かかりつけ医がいる人(68.1％、いない人32.7％)、大都市圏居住者(68.1％、非大都市圏64.4％)にて検査率が高く、また、世帯年収、学歴が高いほど高かった(年間世帯年収$75,000以上：70.8％、大卒：70.7％)。65～75歳でも同様に女性(80.1％、男性：78.2％)、医療保険加入者(79.7％、未加入者：55.7％)、かかりつけ医がいる人(81.6％、いない人：45.6％)、大都市圏居住者(80.2％、非大都市圏：77.6％)にて高く、世帯年収および学歴の高いほど高かった(世帯年収$75,000以上：87.1％、大卒：85.0％)。州別ではマサチューセッツ州にて全体、64～75歳ともにもっとも高く(各76.5％、72.1％)、ワイオミング州にてともにもっとも低かった(各57.8％、51.5％)。65～75歳はロードアイランド州にてもっとも高く(84.9％)、ワイオミング州にてもっとも低かった(68.5％)。また、50～64歳では70.5％以上の州が4州、60％未満の州が11州、65～75歳では49州およびワシントンDCで70.5％以上であった。以上、CRCのスクリーニング検査率は50～64歳では65～75歳に比べて15.9パーセントポイント低く、今後は、50歳から75歳までの人に対し、CRCのスクリーニング検査を推奨する必要性が示唆された。

References

US Cancer Statistics Working Group. United States cancer statistics: data visualizations. Atlanta, GA: US Department of Health and Human Services, CDC; 2019. ＜https://www.cdc.gov/cancer/dataviz＞
Bibbins-Domingo K, Grossman DC, Curry SJ, et al.; US Preventive Services Task Force. Screening for colorectal cancer: US Preventive Services Task Force recommendation statement. JAMA 2016;315:2564–75. ＜https://doi.org/10.1001/jama.2016.5989＞
National Cancer Institute. SEER*Explorer. Bethesda, MD: US Department of Health and Human Services, National Institutes of Health, National Cancer Institute; 2019. ＜https://seer.cancer.gov/explorer/＞
Edwards BK, Ward E, Kohler BA, et al. Annual report to the nation on the status of cancer, 1975–2006, featuring colorectal cancer trends and impact of interventions (risk factors, screening, and treatment) to reduce future rates. Cancer 2010;116:544–73. ＜https://doi.org/10.1002/cncr.24760＞
US Department of Health and Human Services. Healthy people 2020. Washington, DC: US Department of Health and Human Services, Office of Disease Prevention and Health Promotion; 2020. ＜https://www.healthypeople.gov/2020/leading-health-indicators/2020-lhi-topics/ Clinical-Preventive-Services＞
CDC. Behavioral Risk Factor Surveillance System survey data. Atlanta, GA: US Department of Health and Human Services, CDC; 2018. ＜https://www.cdc.gov/brfss/＞
Hall IJ, Tangka FKL, Sabatino SA, Thompson TD, Graubard BI, Breen N. Patterns and trends in cancer screening in the United States. Prev Chronic Dis 2018;15:E97. ＜https://doi.org/10.5888/pcd15.170465＞
Halm EA, Beaber EF, McLerran D, et al. Association between primary care visits and colorectal cancer screening outcomes in the era of population health outreach. J Gen Intern Med 2016;31:1190–7. ＜https:// doi.org/10.1007/s11606-016-3760-9＞
Mojica CM, Bradley SM, Lind BK, Gu Y, Coronado GD, Davis MM. Initiation of colorectal cancer screening among Medicaid enrollees. Am J Prev Med 2020;58:224–31. ＜https://doi.org/10.1016/j.amepre.2019.09.015＞
Weiss JM, Smith MA, Pickhardt PJ, et al. Predictors of colorectal cancer screening variation among primary-care providers and clinics. Am J Gastroenterol 2013;108:1159–67. ＜https://doi.org/10.1038/ajg.2013.127＞
Wernli KJ, Hubbard RA, Johnson E, et al. Patterns of colorectal cancer screening uptake in newly eligible men and women. Cancer Epidemiol Biomarkers Prev 2014;23:1230–7. ＜https://doi.org/10.1158/1055-9965. EPI-13-1360＞
Knudsen AB, Zauber AG, Rutter CM, et al. Estimation of benefits, burden, and harms of colorectal cancer screening strategies: modeling study for the U.S. Preventive Services Task Force. JAMA 2016;315:2595–609. ＜https://doi.org/10.1001/jama.2016.6828＞
Honein-AbouHaidar GN, Kastner M, Vuong V, et al. Systematic review and meta-study synthesis of qualitative studies evaluation facilitators and barriers to participation in colorectal cancer screening. Cancer Epidemiol Biomarkers Prev 2016;25:907–17. ＜https://doi.org/10.1158/1055-9965.EPI-15-0990＞
Muthukrishnan M, Arnold LD, James AS. Patients’ self-reported barriers to colon cancer screening in federally qualified health center settings. Prev Med Rep 2019;15:100896. ＜https://doi.org/10.1016/j. pmedr.2019.100896＞
Nagelhout E, Comarell K, Samadder NJ, Wu YP. Barriers to colorectal cancer screening in a racially diverse population served by a safety-net clinic. J Community Health 2017;42:791–6. ＜https://doi.org/10.1007/ s10900-017-0319-6＞
Inadomi JM, Vijan S, Janz NK, et al. Adherence to colorectal cancer screening: a randomized clinical trial of competing strategies. Arch Intern Med 2012;172:575–82. ＜https://doi.org/10.1001/archinternmed.2012.332＞
Nielson CM, Vollmer WM, Petrik AF, Keast EM, Green BB, Coronado GD. Factors affecting adherence in a pragmatic trial of annual fecal immunochemical testing for colorectal cancer. J Gen Intern Med 2019;34:978–85. ＜https://doi.org/10.1007/s11606-018-4820-0＞
Liu BY, O’Malley J, Mori M, et al. The association of type and number of chronic diseases with breast, cervical, and colorectal cancer screening. J Am Board Fam Med 2014;27:669–81. ＜https://doi.org/10.3122/ jabfm.2014.05.140005＞
Meester RG, Doubeni CA, Zauber AG, et al. Public health impact of achieving 80% colorectal cancer screening rates in the United States by 2018. Cancer 2015;121:2281–5. ＜https://doi.org/10.1002/cncr.29336＞
US Department of Health and Human Services. The Community Guide. Atlanta, GA: US Department of Health and Human Services; 2020. ＜https://www.thecommunityguide.org/＞