影響台灣男性接受癌症篩檢的因素與醫療服務利用探討-以大腸癌與攝護腺癌為例

研究目的藉由使用國內大規模健康調查資料，以男性參加大腸癌、攝護腺癌篩檢病患為對象，對其社會人口學因子(如年齡、教育程度、婚姻狀況、籍貫、宗教信仰、家戶所得及工作狀態等)、健康狀態(如自覺健康狀態，日常生活活動限制，常見慢性疾病等)、過去一年醫療服務利用(包含門診及住院)、個人健康行為(如固定的運動習慣、不抽菸)等特性進行分析並了解與男性參加癌症篩檢的相關性，並進而探討影響台灣男性癌症篩檢行為的預測因子，研究結果可作為政府提升癌症篩檢率的相關醫療衛生政策的參考。研究方法本研究使用民國九十年完成之「國民健康訪問調查」，研究樣本為40歲以上男性民眾並排除自受訪日前共計一年有結直腸癌、攝護腺癌診斷者，共3539位，以回溯性橫斷式資料進行分析，運用SPSS14.0統計軟體分析工具，進行描述性及推論性比較分析。研究結果本研究發現台灣男性過去一年是否接受過癌症篩檢隨著下列因子呈現顯著的差異，包含社會人口學因子中的年齡、教育程度、婚姻狀況、籍貫、家戶所得及工作狀態、自覺健康狀態(包括心理健康及生理健康)，日常生活活動限制，常見慢性疾病、過去一年醫療服務利用(包含門診及住院次數)、個人健康行為(包括固定的運動習慣、不抽菸)；而影響台灣男性過去一年是否接受過癌症篩檢的預測因子有年齡、教育程度、籍貫、家戶所得、常見慢性疾病、過去一年門診次數、過去一年住院次數、固定的運動習慣和不抽菸。結論與建議根據本研究發現台灣男性過去一年是否接受癌症篩檢之相關因子及預測因子，建議相關衛生主管機關訂定提高癌症篩檢率的策略，例如，提高原住民接受癌症篩檢的可近性，可用金錢的補助或其他的配套措施來提升家戶所得較低者接受癌症篩檢的意願，對於沒有常見慢性病的民眾和很少使用醫療服務的民眾加強宣導癌症篩檢的好處，繼續推廣國民的健康行為如培養固定的運動習慣及不抽菸等；而國人男性參與癌症篩檢的比例遠低於先進國家，衛生主管機關應於各種管道宣導對各項癌症的知識與篩檢好處的認知，並普遍提升教育水準，進而提高篩檢率，來達到提昇國民健康、節制癌症醫療費用之目標。

關鍵字

癌症篩檢；大腸癌；攝護腺癌

並列摘要

Objective By using the domestic large-scale health survey data and focus on male participating in colorectal cancer and prostate cancer screening, we analyzed their characteristics of social-demographic factors (such as age, education level, marital status, place of origin, religion, household income and work status), health status (such as health-related Quality of Life, activities of daily living limitations, common chronic diseases), use of medical services over the past year (including outpatient and inpatient), personal health behaviors (such as regular exercise habits, not smoking), understanding their correlations with whether male participating in cancer screening, and then explored the factors affecting male in Taiwan participating cancer screening. The research results can be as the reference for government health policy related to increase uptake of cancer screening. Methods The data of this research comes from the National Health Interview Survey questionnaires of Taiwan in 2001. There are 3,539 male selected, they are over age of 40 and excluding who had the diagnosis of colorectal cancer or prostate cancer over the past year. Statistical analysis has been carried out by using retrospective cross-sectional data. Descriptive and inferential comparative analysis has been conducted by using SPSS14.0 statistical software. Results This study found that men in Taiwan whether to accept cancer screening over the past year show significant differences with the following factors: demographic factors including the age, educational level, marital status, place of origin, household income and work status, health-related Quality of Life (including mental health and physical health), activities of daily living limitations, common chronic diseases, use of medical services over the past year (including the number of outpatient and inpatient visit), personal health behavior (including regular exercise habits, not smoking). The factors affecting male in Taiwan participating cancer screening over the past year include age, educational level, place of origin, household income, common chronic diseases, the number of outpatient visits over the past year, the number of hospitalization over the past year, the fixed habit of exercise and not smoking. Conclusions and suggestions According to this research, we found the factors affecting male in Taiwan whether to accept the cancer screening over the past year, and suggested that the relevant health authorities to set a strategy to improve uptake of cancer screening. For example, they can improve aboriginal accessibility for cancer screening, provide available grant money or other support measures to improve the will for cancer screening of the people with low household income, for people who have no common chronic diseases and people who rarely use medical services, enhance public awareness of the benefits of cancer screening, continue to promote national health behaviors such as regular exercise habits and not smoking. In Taiwan, the proportion of male participating in cancer screening is much lower than developed countries, health authorities should use various channels to propaganda knowledge about the benefits of cancer screening, generally improve the standard of education, and thus improving cancer screening rates, to achieve the goals of improving national health and lowering medical costs of cancer.