Halabi S, Skinner C S, Samsa G P, Strigo T S, Crawford Y S, Rimer B K
Department of Community and Family Medicine, Duke University Medical Center, Durham, NC 27710, USA.
J Fam Pract. 2000 Dec;49(12):1104-12.
Even organizations with differing mammography recommendations agree that regular repeat screening is required for mortality reduction. However, most studies have focused on one-time screening rather than repeat adherence. We compare trends in beliefs and health-related behaviors among women screened and adherent to the National Cancer Institute's screening mammography recommendations (on schedule), those screened at least once and nonadherent (off schedule), and those never screened.
Our data are from a baseline telephone interview conducted among 1,287 female members of Blue Cross Blue Shield of North Carolina who were aged either 40 to 44 years or 50 to 54 years.
The 3 groups differed significantly on beliefs and health-related behaviors, with the off-schedule group almost consistently falling between the on-schedule and never screened groups. Off-schedule women were more likely than on-schedule women, but less likely than those never screened, to not have a clinical breast examination within 12 months, to be ambivalent about screening mammography, to be confused about screening guidelines, and to not be advised by a physician to get a mammogram in the past 2 years. Off-schedule women perceived their breast cancer risk as lower and were less likely to be up to date with other cancer screening tests.
Our findings suggest that women who are off schedule are in need of mammography-promoting interventions, including recommendations from and discussion with their health care providers. Because they are more positive and knowledgeable about mammography than women who have never been screened, they may benefit from brief interventions from health care providers that highlight the importance of repeat screening.
即使是对乳房X光检查建议存在差异的组织也一致认为,定期重复筛查对于降低死亡率是必要的。然而,大多数研究都集中在一次性筛查上,而非重复筛查的依从性。我们比较了按照美国国立癌症研究所的乳房X光筛查建议进行筛查并坚持(按时)的女性、至少接受过一次筛查但未坚持(未按时)的女性以及从未接受过筛查的女性在观念和健康相关行为方面的趋势。
我们的数据来自对北卡罗来纳州蓝十字蓝盾公司1287名年龄在40至44岁或50至54岁之间的女性会员进行的基线电话访谈。
这三组在观念和健康相关行为方面存在显著差异,未按时组几乎始终处于按时组和从未筛查组之间。未按时接受筛查的女性比按时接受筛查的女性更有可能,但比从未接受筛查的女性更不可能在12个月内未进行临床乳房检查、对乳房X光筛查持矛盾态度、对筛查指南感到困惑以及在过去两年中未得到医生建议进行乳房X光检查。未按时接受筛查的女性认为自己患乳腺癌的风险较低,并且不太可能及时进行其他癌症筛查。
我们的研究结果表明,未按时接受筛查的女性需要促进乳房X光检查的干预措施,包括来自医疗保健提供者的建议以及与其进行讨论。由于她们对乳房X光检查比从未接受过筛查的女性更积极且更了解,她们可能会从医疗保健提供者的简短干预中受益,这些干预强调了重复筛查的重要性。