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1.
J Community Health ; 43(6): 1093, 2018 12.
Artigo em Inglês | MEDLINE | ID: mdl-29882181

RESUMO

The original version of this article unfortunately contained a mistake. There is a typo in the coauthor name, it should be Franklin G. Berger.

2.
J Community Health ; 43(6): 1085-1092, 2018 12.
Artigo em Inglês | MEDLINE | ID: mdl-29767821

RESUMO

The rates of colorectal cancer (CRC) screening in the U.S. remain below national targets, so many people at risk are not being screened. The objective of this qualitative research project was to assess patient and provider knowledge and preferences about CRC screening modalities and specifically the use of the fecal immunochemical test (FIT) as a first line screening choice. Nine focus groups were conducted with a medically underserved patient population and qualitative interviews were administered to their medical providers. Thematic analysis was used to synthesize key findings. Both providers and patients thought that the FIT would be a good option for CRC screening both as an individual choice and for an overall program approach. The test is less expensive and therefore more readily available for patients compared to colonoscopy. Overall, there was consensus that the FIT offers a reasonably priced, simple approach to CRC screening which has broad appeal to both providers and patients. Concerns identified by patients and providers included the possibility of false positives with the FIT which could be caused by test contamination or failing to perform the test properly. Patients also described feelings of disgust toward performing the FIT and difficulties in following the instructions. Study findings indicate provider and patient support for using the FIT for CRC screening at both the individual and system-wide levels of implementation. While barriers to the use of the FIT were listed, benefits of using the FIT were perceived as positive motivators to engage previously unscreened and uninsured or under-insured individuals in CRC screening.


Assuntos
Colonoscopia/estatística & dados numéricos , Neoplasias Colorretais/prevenção & controle , Serviços de Saúde Comunitária/métodos , Detecção Precoce de Câncer/estatística & dados numéricos , Pessoas sem Cobertura de Seguro de Saúde/psicologia , Sangue Oculto , Colonoscopia/psicologia , Neoplasias Colorretais/diagnóstico , Neoplasias Colorretais/psicologia , Feminino , Humanos , Área Carente de Assistência Médica , Pessoas sem Cobertura de Seguro de Saúde/estatística & dados numéricos , Pessoa de Meia-Idade , Pesquisa Qualitativa
3.
Dig Dis Sci ; 61(1): 265-72, 2016 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-26386856

RESUMO

BACKGROUND: Compared to whites, blacks have higher colorectal cancer incidence and mortality rates and are at greater risk for early-onset disease. The reasons for this racial disparity are poorly understood, but one contributing factor could be differences in access to high-quality screening and medical care. AIMS: The present study was carried out to assess whether a racial difference in prevalence of large bowel polyps persists within a poor and uninsured population (n = 233, 124 blacks, 91 whites, 18 other) undergoing screening colonoscopy. METHODS: Eligible patients were uninsured, asymptomatic, had no personal history of colorectal neoplasia, and were between the ages 45-64 years (blacks) or 50-64 years (whites, other). We examined the prevalence of any adenoma (conventional, serrated) and then difference in adenoma/polyp type by race and age categories. RESULTS: Prevalence for ≥1 adenoma was 37 % (95 % CI 31-43 %) for all races combined and 36 % in blacks <50 years, 38 % in blacks ≥50 years, and 35 % in whites. When stratified by race, blacks had a higher prevalence of large conventional proximal neoplasia (8 %) compared to whites (2 %) (p value = 0.06) but a lower prevalence of any serrated-like (blacks 18 %, whites 32 %; p value = 0.02) and sessile serrated adenomas/polyps (blacks 2 %, whites 8 % Chi-square p value; p = 0.05). CONCLUSIONS: Within this uninsured population, the overall prevalence of adenomas was high and nearly equal by race, but the racial differences observed between serrated and conventional polyp types emphasize the importance of taking polyp type into account in future research on this topic.


Assuntos
Pólipos Adenomatosos/etnologia , Negro ou Afro-Americano , Neoplasias do Colo/etnologia , Pólipos do Colo/etnologia , Pessoas sem Cobertura de Seguro de Saúde/etnologia , Pobreza/etnologia , População Branca , Pólipos Adenomatosos/diagnóstico , Pólipos Adenomatosos/economia , Neoplasias do Colo/diagnóstico , Neoplasias do Colo/economia , Pólipos do Colo/diagnóstico , Pólipos do Colo/economia , Colonoscopia , Feminino , Disparidades nos Níveis de Saúde , Disparidades em Assistência à Saúde/economia , Disparidades em Assistência à Saúde/etnologia , Humanos , Masculino , Pessoa de Meia-Idade , Pobreza/economia , Valor Preditivo dos Testes , Prevalência , Fatores de Risco , South Carolina/epidemiologia
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