Geospatial analysis of the influence of family doctor on colorectal cancer screening adherence
Autor: | Alessio Gili, Basilio Passamonti, Fortunato Bianconi, Giulia Naldini, Fabrizio Stracci, Morena Malaspina, Vincenza Gianfredi |
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Přispěvatelé: | Stracci, F., Gili, A., Naldini, G., Gianfredi, V., Malaspina, M., Passamonti, B., Bianconi, F. |
Rok vydání: | 2019 |
Předmět: |
Male
European People Colorectal cancer Psychological intervention 0302 clinical medicine Cancer screening Medicine and Health Sciences Ethnicities Mass Screening Public and Occupational Health 030212 general & internal medicine Geographic Areas education.field_of_study Multidisciplinary Geography Physicians Family Colonoscopy Middle Aged Socioeconomic Aspects of Health Italian People Oncology Italy Research Design 030220 oncology & carcinogenesis Medicine Female Colorectal Neoplasms Cancer Screening Research Article Census medicine.medical_specialty Aged Humans Patient Compliance Sex Factors Physician-Patient Relations Science Population MEDLINE Research and Analysis Methods 03 medical and health sciences Diagnostic Medicine Physicians Environmental health Cancer Detection and Diagnosis medicine Family education Socioeconomic status Mass screening Colorectal Cancer Survey Research Public health Cancers and Neoplasms medicine.disease Health Care Age Groups People and Places Earth Sciences Population Groupings |
Zdroj: | PLoS ONE, Vol 14, Iss 10, p e0222396 (2019) PLoS ONE |
ISSN: | 1932-6203 |
Popis: | BackgroundDespite the well-recognised relevance of screening in colorectal cancer (CRC) control, adherence to screening is often suboptimal. Improving adherence represents an important public health strategy. We investigated the influence of family doctors (FDs) as determinant of CRC screening adherence by comparing each FDs practice participation probability to that of the residents in the same geographic areas using the whole population geocoded.MethodsWe used multilevel logistic regression model to investigate factors associated with CRC screening adherence, among 333,843 people at their first screening invitation. Standardized Adherence Rates (SAR) by age, gender, and socioeconomic status were calculated comparing FDs practices to the residents in the same geographic areas using geocoded target population.ResultsScreening adherence increased from 41.0% (95% CI, 40.8-41.2) in 2006-2008 to 44.7% (95% CI, 44.5-44.9) in 2011-2012. Males, the most deprived and foreign-born people showed low adherence. FD practices and the percentage of foreign-born people in a practice were significant clustering factors. SAR for 145 (21.4%) FDs practices differed significantly from people living in the same areas. Predicted probabilities of adherence were 31.7% and 49.0% for FDs with low and high adherence, respectively.DiscussionFDs showed a direct and independent effect to the CRC screening adherence of the people living in their practice. FDs with significantly high adherence level could be the key to adherence improvement.ImpactMost deprived individuals and foreigners represent relevant targets for interventions in public health aimed to improve CRC screening adherence. |
Databáze: | OpenAIRE |
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