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Abstract

Background: Hepatitis infection is a global burden disease, screening for hepatitis to early detection asymptomatic hematoma for reduced mortality were emphasized in community health policy.

Aim: To assess the association between liver function related biomarkers and the time to adoption the novelty multiple cancer screening program underpinning the Diffusion of Innovation (DOI) theory.

Design: A longitudinal follow up study.

Method: Based on the definition of DOI theory, all participants were classified the adoption of innovativeness community based integrated screening program in Keelung, Taiwan since 2001 to 2010, according to time to firstly attend screening into five categories. Structured questionnaires for collection the demographic information and lifestyle related factors, as well as biomarkers were drawn from blood sample by standard laboratory. The Chi-square tests were used to examine the significant difference between these explanatory factors and levels of innovativeness. The survival time was defined as the time interval between January 1st, 2001 and the day of first adoption. The multi variable cox proportional hazards regression model was further applied by including all significant factors.

Results: In a total of 57,939 subjects were recruited in the current analysis. The mean time to adopt the innovation screening was 3.48 (± 2.70) years. The characteristics of married elderly female with lower educational level and with healthy lifestyle of regular exercise, no smoking and no drinking habits groups had higher proportion of being adopted the innovative screening earlier (p<0.0001). Subjects with elevated level of albumin, globulin, total protein and ALT, negative status of HBsAg (p<0.0001) and anti HCV positive (p=0.0222) were earlier to adopt the innovation.

Conclusion: This innovativeness screening program was successfully diffused in community. Health professional should prioritize provide education and integrated screening to community population may threatening of hepatitis and liver function change for early prevention the cancer and reduce mortality.