adherence to cancer screening guidelines across canadian provinces an observational study坚持癌症筛查指南在加拿大省份一项观察性研究.pdfVIP

Strumpf et al. BMC Cancer 2010, 10:304 /1471-2407/10/304 R E S E A R C H A R T I C L E Open Access Research article Adherence to cancer screening guidelines across Canadian provinces: an observational study 1,2 3 4 Erin C Strumpf* , Zhijin Chai and Srikanth Kadiyala Abstract Background: Cancer screening guidelines reflect the costs and benefits of population-based screening based on evidence from clinical trials. While most of the existing literature on compliance with cancer screening guidelines only measures raw screening rates in the target age groups, we used a novel approach to estimate degree of guideline compliance across Canadian provinces for breast, colorectal and prostate cancer screening. Measuring compliance as the change in age-specific screening rates at the guideline-recommended initiation age (50), we generally found screening patterns across Canadian provinces that were not consistent with guideline compliance. Methods: We calculated age-cancer-specific screening rates for ages 40-60 using the Canadian Community Health Survey (2003 and 2005), a cross-sectional, nationally representative survey of health status, health care utilization and health determinants in the Canadian population. We estimated the degree of compliance using logistic regression to measure the change in adjusted screening rates at the guideline-recommended initiation age for each province in the sample. Results: For breast cancer, after adjusting for age trends and other covariates, being above age 50 in Quebec increased the probability of being screened by 19 percentage points, from an average screening rate of 24% among 40-49 year olds. None of the other regions exhibited a statistically significant change in screening rates at age 50. Additional analyses indicat