| 摘要: | 目的：大腸直腸癌是台灣第三常見癌症死因，我國國民健康局致力推動民眾對大腸直腸癌之認知與早期篩檢之相關工作，本研究目的旨在探討民眾對大腸直腸癌危險因子與保護因子之認知及其預防行為。方法：本研究是經人體試驗委員會審查通過之橫斷性研究，以2011年4月29日至2012年4月20日在南部某教學醫院配合國健局接受糞便潛血篩檢之265位(50歲至69歲)民眾為研究對象，以問卷調查民眾之人口特徵與大腸直腸癌家族史；民眾大腸直腸癌危險因子與保護因子之認知(採0至100計分，0表示非常不同意；100表示非常同意)；民眾飲食方式和生活習慣之行為(是或否量表)。民眾糞便潛血篩檢結果則由癌篩個管師填寫。結果：本研究共計回收250份(94.3%)問卷，整體民眾對大腸直腸癌危險因子與保護因子之認知得分別為69.2±11.4與67.3±11.7。篩檢結果陰性有198位對大腸直腸癌危險因子與保護因子之認知分別高於陽性之52位(危險因子：70.1±11.3 vs. 65.7±10.9, p<0.05；保護因子：68.8±11.9 vs. 61.3±8.9, p<0.001)，篩檢結果陰性者之對大腸直腸癌預防有益的行為表現亦高於篩檢結果陽性者(10.5±1.7 vs. 8.3±2.1, P<0.001)。多元線性迴歸分析結果顯示，年齡可獨立預測民眾之大腸直腸癌危險因子與保護因子之認知，60歲以上民眾之認知比50歲至59歲民眾低(β=-0.17, p<0.05)。此外，民眾對大腸直腸癌危險因子與保護因子之認知對於預防大腸直腸癌有益行為表現具有顯著性之影響(p<0.001)。納入年齡、性別、教育程度與大腸直腸癌家族史等變項之邏輯斯迴歸分析，結果顯示，大腸直腸癌危險因子與保護因子之認知程度與降低陽性篩檢結果之機率有關聯 (OR=0.97; 95%CI, 0.95-0.98)，但是當再投入民眾有益之大腸直腸癌預防行為表現則僅有益之大腸直腸癌預防行為表現降低陽性篩檢結果之機率（OR=0.60; 95%CI, 0.50-0.72)。結論：本研究結果顯示，FOBT篩檢民眾對大腸直腸癌危險因子與保護因子之認知為中等程度，且突顯民眾大腸直腸癌預防之有益的行為表現之重要性。本研究不同年齡層篩檢民眾對大腸直腸癌認知之有差異，50歲至59歲者有較高之大腸直腸癌危險因子與保護因子之認知。
Objectives: Colorectal cancer (CRC) is the third main cause of cancer death in Taiwan. The Taiwanese Bureau of Health Promotion is committed to promoting public awareness of the need for prevention and early detection for colorectal cancer. The aim of this study was to assess the knowledge of risk or protection factors and preventive practices regarding CRC of adults in Taiwan. Methods: This institutional review board-approved cross-sectional study was conducted with 265 subjects (aged 50-69) subjects participating in a community-based fecal occult blood testing (FOBT) screening program at a teaching hospital in southern Taiwan between 29 April 2011 and 20 April 2012. A self-administered questionnaire on demographic characteristics and family history of CRC; knowledge regarding risk and protection factors on a scale of 0 to 100 (0 indicates strongly disagree and 100 indicates strongly disagree); dietary and lifestyle practices on a two-point of yes/no scale was employed. The results of FOBT were filled out by the FOBT case manager. Results: Two hundred fifty subjects (94.3%) responded. Of all the subjects, the mean score of knowledge regarding CRC risk and protection factors had 69.2±11.4 and 67.3±11.7 respectively. Compared with subjects receiving positive FOBT results (n=52), subjects receiving negative FOBT results (n=198) had higher knowledge score about CRC risk and protection factors (risk factors:70.1±11.3 vs. 65.7±10.9, p<0.05; protection factors: 68.8±11.9 vs. 61.3±8.9, p<0.001) and were more likely to perform the beneficial CRC preventive practices (10.5±1.7 vs. 8.3±2.1, P<0.001). In the multiple linear regression, only age was an independent determinants of the knowledge regarding CRC risk and protection factors, the subjects aged above 60 had lower knowledge score (β=-0.17, p<0.05) about risk and protection factors than those aged from 50 to 59; moreover, the knowledge regarding CRC risk and protection factors was significant for predicting beneficial CRC preventive practices in the present subjects (p<0.001). In a logistic regression model including age, sex, education and family history of CRC variables showed that the knowledge regarding CRC risk and protection factors was associated with lower positive FOBT results (OR=0.97; 95% CI, 0.95-0.98), whereas only the performance of beneficial CRC preventive practices was associated with lower positive FOBT results (OR=0.60; 95% CI, 0.50-0.72) when it was incorporated in the model. Conclusions: The results of FOBT screening population survey reveal moderate awareness of CRC risk and protection factors and emphasize the importance of beneficial CRC preventive practices. There are age-related differences in knowledge regarding CRC risk and protection factors, which is higher among younger people aged from 50 to 59. |
