Meiser B, Butow P, Barratt A, Friedlander M, Kirk J, Gaff C, Haan E, Aittomäki K, Tucker K
Hereditary Cancer Clinic, Prince of Wales Hospital, Sydney, NSW, Australia.
Breast Cancer Res Treat. 2000 Jan;59(2):101-11. doi: 10.1023/a:1006330631832.
This multicenter study assessed breast cancer screening uptake in 461 unaffected women at increased risk of developing breast cancer on the basis of family history who approached familial cancer clinics for advice about surveillance options. At the time of attending the clinic, 89% and 90% of participants were vigilant with respect to age- and risk-specific recommendations for mammography and clinical breast examination, respectively, and 51% reported practicing breast self-examination monthly or more frequently. The degree to which health outcomes are perceived to be under one's personal control (chi2 = -2.09, p = 0.0037) and breast cancer anxiety (chi2 = 8.11, p = 0.044) were both associated with monthly or more frequent breast self-examination, while there were no associations with sociodemographic characteristics. A significantly lower percentage (56%) of women aged <30 were vigilant with respect to mammography recommendations, compared to 77%, 96% and 98% of women aged 30-39, 40-49 and >50, respectively (chi2 = 37.2, p < 0.0001). These relatively low rates of mammographic screening in young women may reflect concerns about increased cancer risk associated with early and repeated radiation exposure or lack of sensitivity in young women with radiographically dense breasts. If mammographic screening is ultimately shown to lower mortality in women at high risk, there will be a strong case to promote screening in young women. The need for regular mammographic screening would then need to be highlighted and reinforced amongst young women and their referring physicians. Awareness amongst general practitioners, who are largely responsible for referral to screening services, would also need to be increased.
这项多中心研究评估了461名未患乳腺癌但因家族病史而患癌风险增加的女性的乳腺癌筛查情况，这些女性前往家族癌症诊所咨询监测方案。在就诊时，分别有89%和90%的参与者遵循了针对年龄和风险的乳房X光检查及临床乳房检查建议，51%的参与者报告每月或更频繁地进行乳房自我检查。认为健康结果在个人可控范围内的程度（卡方值=-2.09，p=0.0037）和乳腺癌焦虑程度（卡方值=8.11，p=0.044）均与每月或更频繁的乳房自我检查相关，而与社会人口学特征无关。年龄小于30岁的女性中，遵循乳房X光检查建议的比例显著较低（56%），而年龄在30 - 39岁、40 - 49岁和大于50岁的女性这一比例分别为77%、96%和98%（卡方值=37.2，p<0.0001）。年轻女性中乳房X光检查率相对较低，可能反映出她们担心早期和反复辐射暴露会增加癌症风险，或者担心乳房X光片显示致密的年轻女性乳房缺乏敏感性。如果最终证明乳房X光检查能降低高危女性的死亡率，那么就有充分理由推动年轻女性进行筛查。届时，需要向年轻女性及其转诊医生强调并强化定期进行乳房X光检查的必要性。还需要提高主要负责转诊至筛查服务的全科医生的认识。
