Secker-Walker R H, Vacek P M, Hooper G J, Plante D A, Detsky A S
Office of Health Promotion Research, University of Vermont, Burlington, USA.
J Natl Cancer Inst. 1999 Apr 21;91(8):702-8. doi: 10.1093/jnci/91.8.702.
We estimated the personal costs to women found to have a breast problem (either breast cancer or benign breast disease) in terms of time spent, miles traveled, and cash payments made for detection, diagnosis, initial treatment, and follow-up.
We analyzed data from personal interviews with 465 women from four communities in Florida. These women were randomly selected from those with a recent breast biopsy (within 6-8 months) that indicated either breast cancer (208 women) or benign breast disease (257 women). One community was the site of a multifaceted intervention to promote breast screening, and the other three communities were comparison sites for evaluation of that intervention. All P values are two-sided.
In comparison with time spent and travel distance for women with benign breast disease (13 hours away from home and 56 miles traveled), time spent and travel distance were statistically significantly higher (P<.001) for treatment and follow-up of women with breast cancer (89 hours and 369 miles). Personal financial costs for treatment of women with breast cancer were also statistically significantly higher (breast cancer = $604; benign breast disease = $76; P < .001) but were statistically significantly lower for detection and diagnosis (breast cancer = $170; benign breast disease = $310; P < .001). Among women with breast cancer, time spent for treatment was statistically significantly lower (P = .013) when their breast cancer was detected by screening (68.9 hours) than when it was detected because of symptoms (84.2 hours). Personal cash payments for detection, diagnosis, and treatment were statistically significantly lower among women whose breast problems were detected by screening than among women whose breast problems were detected because of symptoms (screening detected = $453; symptom detected = $749; P = .045).
There are substantial personal costs for women who are found to have a breast problem, whether the costs are associated with problems identified through screening or because of symptoms.
我们估算了被查出患有乳房问题（乳腺癌或良性乳腺疾病）的女性在时间、行程以及用于检查、诊断、初始治疗和后续跟进的现金支付方面的个人成本。
我们分析了对佛罗里达州四个社区的465名女性进行个人访谈的数据。这些女性是从近期（6 - 8个月内）进行乳房活检且结果显示为乳腺癌（208名女性）或良性乳腺疾病（257名女性）的人群中随机选取的。其中一个社区是开展多方面干预措施以促进乳房筛查的地点，另外三个社区作为该干预措施评估的对照地点。所有P值均为双侧。
与患有良性乳腺疾病的女性所花费的时间和行程（离家13小时，行程56英里）相比，乳腺癌女性在治疗和后续跟进方面所花费的时间和行程在统计学上显著更高（P <.001）（89小时和369英里）。乳腺癌女性的个人治疗费用在统计学上也显著更高（乳腺癌 = 604美元；良性乳腺疾病 = 76美元；P <.001），但在检查和诊断方面在统计学上显著更低（乳腺癌 = 170美元；良性乳腺疾病 = 310美元；P <.001）。在乳腺癌女性中，通过筛查发现乳腺癌时的治疗时间在统计学上显著更低（P =.013）（68.9小时），而因出现症状发现乳腺癌时的治疗时间为（84.2小时）。通过筛查发现乳房问题的女性在检查、诊断和治疗方面的个人现金支付在统计学上显著低于因出现症状发现乳房问题的女性（筛查发现 = 453美元；症状发现 = 749美元；P =.045）。
被查出患有乳房问题的女性会产生巨大的个人成本，无论这些成本是与通过筛查发现的问题还是因出现症状而发现的问题相关。
