Segura J M, Castells X, Casamitjana M, Macià F, Ferrer F
CAP Dr. Sayé, Institut Català de la Salut, Barcelona, Spain.
J Clin Epidemiol. 2000 Jun;53(6):595-603. doi: 10.1016/s0895-4356(99)00201-2.
Factors associated with the level of utilization of screening mammography as a preventive practice were analyzed prior to initiating a population-based breast cancer screening program. A questionnaire was used to collect information about screening mammography utilization during the last 4 years among women invited to enroll in the program. Sociodemographic and health factors, and health services utilization were studied. A screening mammography in the last 4 years had been performed on 59.3% of the 8867 women interviewed. The utilization of mammography was higher among women who were younger, had a higher education level, or had previous visits to a physician (P < 0.001). The variables more strongly associated with use of screening mammography were: visit to a gynecologist and performance of a pap smear. Also associated with the utilization of screening mammography were: personal history of breast pathology, family history of breast cancer, breast self-examination, and recent visit to a general practitioner. Self-perceived health presented an inverse relation with screening mammography use (P < 0.001). The use of screening mammography appears to have increased in recent years, although inequalities persist which the breast cancer screening programs help to modulate. Mammographic frequency only would be deemed appropriate by the European guidelines in fewer than one-half of the cases.
在启动一项基于人群的乳腺癌筛查项目之前，对与乳腺钼靶筛查作为一种预防措施的利用水平相关的因素进行了分析。采用问卷调查收集受邀参加该项目的女性在过去4年中乳腺钼靶筛查利用情况的信息。对社会人口统计学和健康因素以及卫生服务利用情况进行了研究。在接受访谈的8867名女性中，59.3%的女性在过去4年中进行过乳腺钼靶筛查。年龄较小、教育水平较高或之前看过医生的女性乳腺钼靶筛查的利用率较高（P<0.001）。与乳腺钼靶筛查使用关联更强的变量是：看妇科医生和进行巴氏涂片检查。与乳腺钼靶筛查利用情况相关的还有：乳腺疾病个人史、乳腺癌家族史、乳房自我检查以及近期看全科医生。自我感知健康状况与乳腺钼靶筛查使用呈负相关（P<0.001）。近年来乳腺钼靶筛查的使用似乎有所增加，尽管不平等现象仍然存在，而乳腺癌筛查项目有助于对此进行调节。按照欧洲指南，只有不到一半的情况乳腺钼靶检查频率才被认为是合适的。
