尽管人们越来越认识到结构性种族主义会导致少数种族和族裔的健康状况较差，但对于当前种族居住隔离模式与癌症筛查普及率之间的关系，仍存在知识差距。作者研究了非西班牙裔黑人和非西班牙裔白人成年人中黑人居住隔离与结直肠癌 (CRC) 和宫颈癌筛查之间的关联。这是一项针对来自五个医疗保健系统的符合 CRC 和宫颈癌筛查资格的成年人的回顾性研究基于人群的优化筛选过程研究 (PROSPR II) 联盟（队列条目，2010-2012 年）。居住隔离是使用黑人当地隔离得分（LIS）的特定地点四分位数来衡量的。结果是在进入队列后 3 年内（2010-2015 年）接受 CRC 或宫颈癌筛查。 Logistic 回归用于计算 LIS 与筛查完成之间的关联，并调整患者水平的协变量。 在 CRC (n = 642,661) 和宫颈癌 (n = 163,340) 符合筛查资格的患者中，分别有 456,526 名 (71.0%) 和 106,124 名 (65.0%) 患者%)分别接受了筛选。在 PROSPR 站点中，居住在 LIS 较高的社区往往与 CRC 筛查的几率较低相关（北加州 Kaiser Permanente：黑人患者的调整后比值比 [aOR] LIS 趋势，0.95 [p < .001]；aOR LIS 趋势白人患者，0.98 [p < .001]；Kaiser Permanente 南加州：黑人患者的 aOR LIS 趋势，0.98 [p = .026]；白人患者的 aOR LIS 趋势，1.01 [p = .023]；白人患者的 aOR LIS 趋势，0.97 [p = .002] 然而，对于宫颈癌筛查，与 LIS 的关联因地点和种族而异（Kaiser Permanente Washington：白人患者的 aOR LIS 趋势，0.95 [p < .001]。 ；麻省总医院布里格姆医院：黑人患者的 aOR LIS 趋势，1.12 [p < .001]；白人患者的 aOR LIS 趋势，1.03 [p < .001]）。在五个不同的医疗保健系统中，黑人患者之间的关联方向居住隔离和筛查因 PROSPR 地点、种族和筛查类型而异。需要进行更多研究，包括使用交叉方法检查隔离和结构性种族主义的多个维度的研究，以进一步理清这些关系。© 2024 美国癌症协会。

Despite increased recognition that structural racism contributes to poorer health outcomes for racial and ethnic minorities, there are knowledge gaps about how current patterns of racial residential segregation are associated with cancer screening uptake. The authors examined associations between Black residential segregation and screening for colorectal cancer (CRC) and cervical cancer among non-Hispanic Black and non-Hispanic White adults.This was a retrospective study of CRC and cervical cancer screening-eligible adults from five health care systems within the Population-Based Research to Optimize the Screening Process (PROSPR II) Consortium (cohort entry, 2010-2012). Residential segregation was measured using site-specific quartiles of the Black local isolation score (LIS). The outcome was receipt of CRC or cervical cancer screening within 3 years of cohort entry (2010-2015). Logistic regression was used to calculate associations between the LIS and screening completion, adjusting for patient-level covariates.Among CRC (n = 642,661) and cervical cancer (n = 163,340) screening-eligible patients, 456,526 (71.0%) and 106,124 (65.0%), respectively, received screening. Across PROSPR sites, living in neighborhoods with higher LIS tended to be associated with lower odds of CRC screening (Kaiser Permanente Northern California: adjusted odds ratio [aOR] LIS trend in Black patients, 0.95 [p < .001]; aOR LIS trend in White patients, 0.98 [p < .001]; Kaiser Permanente Southern California: aOR LIS trend in Black patients, 0.98 [p = .026]; aOR LIS trend in White patients, 1.01 [p = .023]; Kaiser Permanente Washington: aOR LIS trend in White patients, 0.97 [p = .002]. However, for cervical cancer screening, associations with the LIS varied by site and race (Kaiser Permanente Washington: aOR LIS trend in White patients, 0.95 [p < .001]; Mass General Brigham: aOR LIS trend in Black patients, 1.12 [p < .001]; aOR LIS trend in White patients, 1.03 [p < .001]).Across five diverse health care systems, the direction of the association between Black residential segregation and screening varied by PROSPR site, race, and screening type. Additional research, including studies that examine multiple dimensions of segregation and structural racism using intersectional approaches, are needed to further disentangle these relationships.© 2024 American Cancer Society.