Coleman E A, O'Sullivan P
University of Arkansas for Medical Sciences, Little Rock 72205, USA.
J Women Aging. 2001;13(3):23-39. doi: 10.1300/J074v13n03_03.
Breast cancer mortality is decreasing for elderly white women but increasing for elderly black women. National surveys were used to study racial differences in breast cancer screening and effects of Medicare funding for mammography and to examine explanatory fac- tors. A total of 13,545 women, aged 65-74, from the Health Care Finance Administration's Master Beneficiary File participated. After Medicare funding for screening mammography, the percent reporting a mammogram increased for white women, but not for black women. Clinical breast examination and breast self-examination decreased. Physician's recommendation, geographic area, education level and health status were the variables significantly affecting mammography usage for both races. Physicians recommended mammography more often if women were white, married, educated beyond high school and had an annual income greater than $20,000. These results support the need to design and test strategies specifically for black women and interventions to emphasize physician recommendations for breast cancer screening.
老年白人女性的乳腺癌死亡率正在下降，但老年黑人女性的乳腺癌死亡率却在上升。利用全国性调查研究乳腺癌筛查中的种族差异以及医疗保险对乳房X光检查的资助效果，并探究相关解释因素。共有13545名年龄在65至74岁之间的女性参与了此次调查，她们来自医疗保健财务管理局的主要受益人档案。在医疗保险资助乳房X光检查后，报告进行过乳房X光检查的白人女性比例有所上升，但黑人女性没有。临床乳房检查和乳房自我检查有所减少。医生建议、地理区域、教育水平和健康状况是显著影响两个种族乳房X光检查使用率的变量。如果女性是白人、已婚、受过高中以上教育且年收入超过2万美元，医生更常建议她们进行乳房X光检查。这些结果表明，有必要专门为黑人女性设计并测试相关策略，并采取干预措施来强调医生对乳腺癌筛查的建议。
