E-postama gönder YARI KIRSAL ALANDA YAŞAYAN KİŞİLERDE GAİTADA GİZLİ KAN TARAMASI VE TARAMA PROGRAMLARI HAKKINDA FARKINDALIKLARI - FECAL OCCULT BLOOD SCREENING in PEOPLE LIVING in SEMIRURAL AREA and THEIR AWARENESS about SCREENING PROGRAMS
Öz
Amaç: Çalışmada yarı kırsal alanda yaşayan 50-70 yaş arasındaki kişilerin kolorektal kanser tarama programlarını hakkındaki farkındalıklarının değerlendirilmesi ve gaitada gizli kan testi ile taramalarının yapılması amaçlandı.
Gereç-yöntem: Çalışma, 2015 yılında Eskişehir Osmangazi Üniversitesi Eğitim-Araştırma bölgesinde yer alan Toplum Sağlığı Merkezleri (TSM)’nden rastgele seçilen iki bölgede (Mahmudiye ve Beylikova) yapılan kesitsel tipte bir araştırmadır. TSM’lerin sağlık kayıtlarından ilçe merkezlerinde yaşayan 50-70 yaş arasında 1637 kişinin adres bilgilerine ulaşıldı. Çalışma gün-saatinde, belirlenmiş adreslere gidildi ve 1533 kişiye (%93.6) ulaşıldı.
Çalışmaya katılmayı kabul eden 495 kişi (%32.3) ile anket formu dolduruldu. Daha sonra gaitada gizli kan tarama testini yaptırmayı kabul edenlere, testi nasıl yapacakları anlatılarak test kiti verildi. Dağıtılan kitler 48 saat sonra toplandı. Alınan numuneler klavuzuna uygun olarak
analiz edilerek ‘negatif’, ‘pozitif’ ve ‘geçersiz’ olarak değerlendirildi. Veriler IBM SPSS (versiyon 15.0) paket programında değerlendirildi. Verilerin analizinde KiKare ve çoklu lojistik regresyon analizi kullanıldı.
Bulgular: Çalışma grubunu oluşturanların yaşları 50-70 arasında değişmekte olup ortalama (standart sapma) 59.2 (5.8) yıl idi. Katılımcıların 221’i (%44.6) erkek, 450’si (%90.9) evli, 295’i (%59.6) ilkokul mezunuydu.
Çalışma grubunu oluşturanlardan daha önce gaitada gizli kan tarama testini duyanların sayısı177’si (%35.8) idi. Katılımcılardan çalışmadan önce kolorektal kanserler ile ilgili herhangi bir tarama testi yaptırma sıklığı %19.4 (n=96) olup, tarama testlerini duyanlarda, kadınlarda ve
hekim tanılı kronik hastalığı olanlarda tarama testine katılma oranı daha yüksekti.
Çalışmada 113 (%22.8) kişi gaitada gizli kan tarama testi kitini almak istemedi. Öğrenim düzeyi yüksek olan, gelir durumu kötü olan, akrabalarında kolorektal kanser öyküsü olanlarda gaitada gizli kan tarama testine katılım sıklığı daha fazlaydı. Gaitada gizli kan tarama testi kiti verilen ve sonucu değerlendirmeye alınan 307 katılımcıdan 45’inin (%14.7) sonucu ‘pozitif’ idi.
Sonuç: Kolorektal kanser tarama programlarını duyan kişilerde tarama programlarına katılma sıklığı daha yüksek bulundu. Çalışmada ulaşılan kişilere araştırma hakkında bilgi verildikten gaitada gizli kan tarama testini yapmak istemeyen, kit verilse bile değerlendirmeye alınmayan
kişi orantıları yüksekti. Bu durum gaitada gizli kan tarama testinin toplum tarafından kabul edilebilirliğinin az olduğunu ve uygulanabilirliğinin zorluğunu göstermektedir.
Anahtar Sözcükler: Kanser, kolorektal kanser, tarama programları, farkındalık
FECAL OCCULT BLOOD SCREENING in PEOPLE LIVING in SEMIRURAL AREA and THEIR AWARENESS about SCREENING PROGRAMS
Objective: The aim of the study is to evaluate the awareness of colorectal cancer screening programs among people aged between 50 and 70 living in semirural area and to perform their screening with fecal occult blood screening test.
Material-method: This is a cross-sectional study was conducted among individuals aged 50- 70 years living in two randomly selected regions (Mahmudiye and Beylikova) from Community Health Centers (CHC) in Eskisehir Osmangazi University Training and Research Area in 2015. From the health records of CHCs, the address information of 1637 people living in the district centers between the ages of 50 and 70 was obtained. At the working day-time, the selected addresses were visited and 1533 people were reached (93.6%). A questionnaire was completed with 495 people (32.3%) who agreed to participate in the study. Those who agreed to have the fecal occult blood screening test were given a test kit describing how to carry out the test. Distributed kits were collected after 48 hours. The samples were evaluated as 'negative', 'positive' and 'invalid' according to the guidelines. The data were evaluated in the IBM SPSS (version 15.0) package program. Chi Square and multiple logistic regression analyzes were used in the analysis of the data.
Results: The age of the study group ranged from 50 to 70 years with a mean (standart deviation) of 59.2 (5.8) years. 221 (44.6%) were male, and 450 (90.9%) were married; 295 (82.0%) had primary and lower education level. 177 (35.8%) were aware of hemoccult test among the study group. The frequency of any screening test for colorectal cancer before the study was 19.4% (n = 96) and the participation to the test was higher in women and in patients having physician- diagnosed chronic diseases. In the study, 113 (22.8%) participants did not want to receive the hemoccult test kit. There was a higher frequency of participation in those who had a higher education level, poor income status, and had colorectal cancer stories in their relatives. Of the 307 participants who received the fecal occult blood screening test kit and were subsequently evaluated, 45 (14.7%) were 'positive'.
Conclusion: People who were aware of colorectal cancer screening programs were more likely to participate in screening programs. After being informed about the research, the percentage of people who did not want to participate to the test and even if the kit was given, whose test can not be evaluated was high. This suggests that the community's acceptability of the fecal occult blood screening test is low and its applicability is difficult.
Key Words: Cancer, colorectal cancer, screening programs, awareness
Tam Metin:
ARTICLE 5Referanslar
World Health Organization, 2015, " Ageing and health ". Erişim adresi: http://www.who.int/mediacentre/factsheets/fs404/en/ ( erişim tarihi : 29.12.2016)
World Health Organization, 2016, "Global strategy and action plan on ageing and health (2016-2020) ", Erişim adresi: http://www.who.int/ageing/global-strategy/en/ (erişim tarihi : 29.12.2016 )
Prince, M. J., Wu, F., Guo, Y., Robledo, L. M. G., O'Donnell, M., Sullivan, R., & Yusuf, S. (2015). The burden of disease in older people and implications for health policy and practice. The Lancet, 385(9967), 549-562.
Alwan, A. (2011). Global status report on noncommunicable diseases 2010. World Health Organization.
Segnan, N., J. Patnick, & L. Von Karsa. (2010) European guidelines for quality assurance in colorectal cancer screening and diagnosis. Office for Official Publications of the European Communities.
Stewart, B.W. & C. Wild, World cancer report (2014). international agency for research on cancer. World Health Organization, 2014. 505.
Zubero, M. B., Arana-Arri, E., Pijoan, J. I., Portillo, I., Idigoras, I., López-Urrutia, A., ... & Bujanda, L. (2014). Population-based colorectal cancer screening: comparison of two fecal occult blood test. Frontiers in pharmacology, 4, 175.
Scottish Intercollegiate Guidelines Network (SIGN), (2011) " DiagnosisandManage-mentofColorectalCancer ". Erişim adresi: http://www.sign.ac.uk/guidelines/fulltext/126/index.html (erişim tarihi:10.11.2017)
Hardcastle, J. D., Chamberlain, J. O., Robinson, M. H., Moss, S. M., Amar, S. S., Balfour, T. W., ...& Mangham, C. M. (1996). Randomised controlled trial of faecal-occult-blood screening for colorectal cancer. The Lancet, 348(9040), 1472-1477.
Hewitson, P., Glasziou, P., Watson, E., Towler, B., & Irwig, L. (2008). Cochrane systematic review of colorectal cancer screening using the fecal occult blood test (hemoccult): an update. The American journal of gastroenterology, 103(6), 1541.
Kronborg, O., Fenger, C., Olsen, J., Jørgensen, O. D., & Søndergaard, O. (1996). Randomised study of screening for colorectal cancer with faecal-occult-blood test. The Lancet, 348(9040), 1467-1471.
Mandel, J. S., Church, T. R., Bond, J. H., Ederer, F., Geisser, M. S., Mongin, S. J., ... & Schuman, L. M. (2000). The effect of fecal occult-blood screening on the incidence of colorectal cancer. New England Journal of Medicine, 343(22), 1603-1607.
Mandel, J. S., Bond, J. H., Church, T. R., Snover, D. C., Bradley, G. M., Schuman, L. M., & Ederer, F. (1993). Reducing mortality from colorectal cancer by screening for fecal occult blood. New England Journal of Medicine, 328(19), 1365-1371.
Shaukat, A., Mongin, S. J., Geisser, M. S., Lederle, F. A., Bond, J. H., Mandel, J. S., & Church, T. R. (2013). Long-term mortality after screening for colorectal cancer. New England Journal of Medicine, 369(12), 1106-1114.
European Code Against Cancer (2012). Erişim adresi: http://ec.europa.eu/health-eu/doc/cancercode_en.pdf (erişim tarihi : 10.10.2015)
Lin, J. S., Piper, M. A., Perdue, L. A., Rutter, C. M., Webber, E. M., O'Connor, E., ... & Whitlock, E. P. (2016). Screening for colorectal cancer: updated evidence report and systematic review for the US Preventive Services Task Force. Jama, 315(23), 2576-2594.
Türkiye Sağlık Bakanlığı (2012). "Kolorektal Kanser Tarama Programı Ulusal Standartları", Erişim adresi: http://kanser.gov.tr/Dosya/tarama/kolorektal.pdf (erişim tarihi:20.20.2016)
Türkiye Sağlık Bakanlığı (2013). Türkiye Halk Sağlığı Kurumu, Kanser Daire Başkanlığı. Erişim adresi: http://kanser. gov. tr/index. php/dairefaaliyetleri/kanser-kayitciligi/108-t% C3% BCrkiyede-kanser-kayitcigi (erişim tarihi:20.10.2016)
Ferlay, J., Soerjomataram, I., Dikshit, R., Eser, S., Mathers, C., Rebelo, M., ... & Bray, F. (2015). Cancer incidence and mortality worldwide: sources, methods and major patterns in GLOBOCAN 2012. International journal of cancer, 136(5).
Knudsen, A. B., Zauber, A. G., Rutter, C. M., Naber, S. K., Doria-Rose, V. P., Pabiniak, C., ... & Kuntz, K. M. (2016). Estimation of benefits, burden, and harms of colorectal cancer screening strategies: modeling study for the US Preventive Services Task Force. Jama, 315(23), 2595-2609.
Greiner, K. A., Born, W., Nollen, N., & Ahluwalia, J. S. (2005). Knowledge and perceptions of colorectal cancer screening among urban African Americans. Journal of general internal medicine, 20(11), 977-983.
Woudstra, A. J., Dekker, E., Essink‐Bot, M. L., & Suurmond, J. (2016). Knowledge, attitudes and beliefs regarding colorectal cancer screening among ethnic minority groups in the Netherlands-a qualitative study. Health Expectations, 19(6), 1312-1323.
Le, T. D., Carney, P. A., Lee-Lin, F., Leung, H., Lau, C., Mori, M., ... & Lieberman, D. A. (2011). Differences in Knowledge, Attitudes, Beliefs, and Perceived Risks Regarding Colorectal Cancer Screening Among Chinese, Korean, and Vietnamese Sub-Groups. Gastroenterology, 140(5), S-21.
Arnold, C. L., Rademaker, A., Liu, D., & Davis, T. C. (2017). Changes in colorectal cancer screening knowledge, behavior, beliefs, self-efficacy, and barriers among community health clinic patients after a health literacy intervention. Journal of community medicine & health education, 7(1).
Seeff, L. C., Nadel, M. R., Klabunde, C. N., Thompson, T., Shapiro, J. A., Vernon, S. W., & Coates, R. J. (2004). Patterns and predictors of colorectal cancer test use in the adult US population. Cancer, 100(10), 2093-2103.
Weber, M. F., Banks, E., Ward, R., & Sitas, F. (2008). Population characteristics related to colorectal cancer testing in New South Wales, Australia: results from the 45 and Up Study cohort. Journal of Medical Screening, 15(3), 137-142.
Oliver, J. S., Ewell, P., Nicholls, K., Chapman, K., & Ford, S. A. (2016, January). Differences in Colorectal Cancer Risk Knowledge Among Alabamians: Screening Implications. In Oncology nursing forum (Vol. 43, No. 1).
Huxley, R. R., Ansary‐Moghaddam, A., Clifton, P., Czernichow, S., Parr, C. L., & Woodward, M. (2009). The impact of dietary and lifestyle risk factors on risk of colorectal cancer: a quantitative overview of the epidemiological evidence. International journal of cancer, 125(1), 171-180.
Lu, X., Holt, C. L., Chen, J. C., Le, D., Chen, J., Kim, G. Y., ... & Lee, S. (2016). Is colorectal cancer a western disease? Role of knowledge and influence of misconception on colorectal cancer screening among Chinese and Korean Americans: A mixed methods study. Asian Pacific journal of cancer prevention: APJCP, 17(11), 4885.
Garcia-Alonso, F. J., Tejero, M. H., Cambrodón, D. B., & Bermejo, F. (2017). Knowledge acquired, satisfaction attained and attitudes towards shared decision making in colorectal cancer screening. Annals of Gastroenterology: Quarterly Publication of the Hellenic Society of Gastroenterology, 30(1), 76.
Rees, G., Martin, P. R., & Macrae, F. A. (2008). Screening participation in individuals with a family history of colorectal cancer: a review. European journal of cancer care, 17(3), 221-232.
Juon, H. S., Guo, J., Kim, J., & Lee, S. (2017). Predictors of Colorectal Cancer Knowledge and Screening Among Asian Americans Aged 50-75 years old. Journal of racial and ethnic health disparities, 1-8.
McKinney, S. Y., & Palmer, R. C. (2014). The Influence of gender on colorectal cancer knowledge, screening intention, perceived risk and worry among African Americans in South Florida. Journal of community health, 39(2), 230-238.
Holden, D. J., Jonas, D. E., Porterfield, D. S., Reuland, D., & Harris, R. (2010). Systematic review: enhancing the use and quality of colorectal cancer screening. Annals of internal medicine, 152(10), 668-676.
Ma, G. X., Wang, M. Q., Toubbeh, J., Tan, Y., Shive, S., & Wu, D. (2012). Factors associated with colorectal cancer screening among Cambodians, Vietnamese, Koreans and Chinese living in the United States. North American journal of medicine & science, 5(1), 1.
Warner, E. L., Bodson, J., Mooney, R., Lai, D., Samadder, N. J., & Kepka, D. (2017). Latinas' Colorectal Cancer Screening Knowledge, Barriers to Receipt, and Feasibility of Home-Based Fecal Immunochemical Testing. Journal of immigrant and minority health, 1-10.
Flowers, L., Noel-Miller, C., & Okrent, D. (2013). Colonoscopy screening after the Affordable Care Act: Cost barriers persist for Medicare beneficiaries.
Jones, R. M., Devers, K. J., Kuzel, A. J., & Woolf, S. H. (2010). Patient-reported barriers to colorectal cancer screening: a mixed-methods analysis. American journal of preventive medicine, 38(5), 508-516.
Refback'ler
- Şu halde refbacks yoktur.