Stidley C A, Tollestrup K, Frost F, Bedrick E J, Petersen H V
Department of Family and Community Medicine, University of New Mexico School of Medicine, Albuquerque, New Mexico 87131, USA.
Cancer. 2001 May 1;91(9):1716-23. doi: 10.1002/1097-0142(20010501)91:9<1716::aid-cncr1189>3.0.co;2-0.
In spite of the effectiveness of mammography screening for early detection of breast carcinoma, the use of screening mammography varies widely across racial and ethnic groups. Recently, concerns have been raised about the potential adverse effect a benign breast biopsy may have on subsequent mammography utilization, including subsequent use among minority women.
Computerized health care claims data for 1991 through 1997 from a managed care organization were used to compare mammography use among Hispanic and non-Hispanic women who had had a mammogram followed by an incisional or excisional benign breast biopsy to women who had had a mammogram and no biopsy. Through survival analysis methods, the time-to-next mammogram was compared among these three groups.
The sample included 693 (3.2%) and 289 (1.3%) women who had had a mammogram followed by an incisional biopsy or an excisional biopsy, respectively, and 20,540 (95.4%) women who had had a mammogram and no biopsy. Both Hispanic and non-Hispanic women with a biopsy returned sooner for subsequent mammograms than women without a biopsy (P < 0.0001). Hispanic women without a biopsy returned later than non-Hispanic women without a biopsy (P < 0.0001). However, Hispanic women with an excisional biopsy returned sooner than non-Hispanic women (P < 0.05).
Within a managed care organization, both Hispanic and non-Hispanic women who had had a mammogram followed by a benign breast biopsy returned sooner for a subsequent mammogram than women who had had a mammogram and no biopsy. However, ethnic differences in time-to-next mammogram were observed for women without a biopsy and those with an excisional biopsy. Hispanic women without a biopsy returned later for a subsequent mammogram than non-Hispanic women in similar groups, but those with an excisional biopsy returned sooner.
尽管乳腺钼靶筛查在早期发现乳腺癌方面具有有效性,但乳腺钼靶筛查的使用在不同种族和族裔群体中差异很大。最近,人们对良性乳腺活检可能对后续乳腺钼靶检查利用率产生的潜在不利影响表示担忧,包括少数族裔女性的后续使用情况。
利用一家管理式医疗组织1991年至1997年的计算机化医疗保健理赔数据,比较了接受乳腺钼靶检查后进行切开活检或切除活检的西班牙裔和非西班牙裔女性与接受乳腺钼靶检查但未进行活检的女性的乳腺钼靶检查使用率。通过生存分析方法,比较了这三组女性下次进行乳腺钼靶检查的时间。
样本包括分别接受乳腺钼靶检查后进行切开活检或切除活检的693名(3.2%)和289名(1.3%)女性,以及接受乳腺钼靶检查但未进行活检的20540名(95.4%)女性。接受活检的西班牙裔和非西班牙裔女性比未接受活检的女性更早进行后续乳腺钼靶检查(P<0.0001)。未接受活检的西班牙裔女性比未接受活检的非西班牙裔女性更晚进行后续乳腺钼靶检查(P<0.0001)。然而,接受切除活检的西班牙裔女性比非西班牙裔女性更早进行后续乳腺钼靶检查(P<0.05)。
在一家管理式医疗组织中,接受乳腺钼靶检查后进行良性乳腺活检的西班牙裔和非西班牙裔女性比接受乳腺钼靶检查但未进行活检的女性更早进行后续乳腺钼靶检查。然而,在未接受活检的女性和接受切除活检的女性中,观察到下次进行乳腺钼靶检查的时间存在种族差异。未接受活检的西班牙裔女性比类似群体中的非西班牙裔女性更晚进行后续乳腺钼靶检查,但接受切除活检的西班牙裔女性更早进行后续乳腺钼靶检查。