Strzelczyk Jadwiga Jodi, Dignan Mark B
Department of Radiology, University of Colorado, Health Sciences Center, School of Medicine, Denver 80262, USA.
Ethn Dis. 2002 Winter;12(1):77-86.
The objective of this study was to examine disparities in adherence to screening mammography and, specifically, to investigate whether race/ethnicity, education, age, health insurance, and family history of breast cancer (FHBC), as unique factors and in interactions, influence adherence to recommended follow up on screening mammography.
The study involved retrieval and analyses of data collected by the Colorado Mammography Project (CMAP) for 167,232 diverse (82.8% White, 3.4% Black, 11% Hispanic, 1.6% Asian, 0.6% Native American, and 0.6% "other") screening participants during the 1990-1997 study period.
Subjects' first mammograms captured by CMAP were tracked in the database to identify women who received follow-up recommendations, women who adhered within 12 months and those that did not. Analyses included comparisons of adherence rates among women with various sociodemographic characteristics.
Of the 17,358 women who received follow-up recommendations, 80.7% adhered. Overall, non-White women in each of the racial/ethnic groups were less likely to adhere to recommendations than were White women (P<.05). Also less likely to adhere were the younger, less educated, uninsured/underinsured, and women who reported not having FHBC.
Race/ethnicity appeared to interact with age, education, health insurance, and FHBC to influence the probability of adherence, suggesting the need to explore further cultural, psychosocial, and situational factors.
本研究的目的是检查乳腺钼靶筛查的依从性差异，具体而言，调查种族/族裔、教育程度、年龄、健康保险和乳腺癌家族史（FHBC）作为独特因素及其相互作用是否会影响对乳腺钼靶筛查推荐的后续随访的依从性。
该研究涉及检索和分析科罗拉多乳腺钼靶项目（CMAP）在1990 - 1997年研究期间收集的167,232名不同（82.8%为白人，3.4%为黑人，11%为西班牙裔，1.6%为亚裔，0.6%为美洲原住民，0.6%为“其他”）筛查参与者的数据。
在数据库中追踪CMAP采集的受试者的首次乳腺钼靶检查，以识别接受后续随访建议的女性、在12个月内依从的女性和未依从的女性。分析包括比较具有不同社会人口学特征的女性的依从率。
在17,358名接受后续随访建议的女性中，80.7%依从。总体而言，每个种族/族裔群体中的非白人女性比白人女性更不可能依从建议（P<.05）。年龄较小、教育程度较低、未参保/参保不足以及报告没有乳腺癌家族史的女性也较不可能依从。
种族/族裔似乎与年龄、教育程度、健康保险和乳腺癌家族史相互作用，影响依从的可能性，这表明需要进一步探索文化、心理社会和情境因素。
