乳腺癌筛查、知识与依从性方面的种族差异。
Racial differences in breast cancer screening, knowledge and compliance.
作者信息
Harris Dawne M, Miller Jane E, Davis Diane M
机构信息
Institute for Health, Health Care Policy and Aging Research, Edward J Bloustein School of Planning and Public Policy, Rutgers University, New Brunswick, NJ 08854, USA.
出版信息
J Natl Med Assoc. 2003 Aug;95(8):693-701.
BACKGROUND
Breast cancer is the second leading cause of cancer death among women in the United States. Although the incidence of breast cancer is 13% higher in white women, mortality in black women is 28% higher, due to histological and socioeconomic factors. Existing research regarding racial differences in compliance with breast cancer screening recommendations has found conflicting results.
METHODS
Data on more than 4,500 women were taken from the 1992 National Health Interview Survey, a nationally representative, population-based sample survey. Logistic regression was used to estimate the relative odds of knowledge of breast self-exam (BSE) and mammograms, and compliance with BSE, clinical breast exams (CBE), and mammograms.
RESULTS
Black women were less likely than white women to be aware of and use breast cancer screening tests. However, among women who were aware of screening tests, compliance was higher among black women. Women with low educational attainment, low cancer knowledge, and no usual source of care were less likely to be CBE or mammogram compliant. Socioeconomic differences were larger for the two clinical tests than for BSE.
CONCLUSIONS
Programs should inform women about cancer screening tests and remove barriers that hinder women from receiving clinical screening exams.
背景
在美国，乳腺癌是女性癌症死亡的第二大主要原因。尽管白人女性的乳腺癌发病率比黑人女性高13%，但由于组织学和社会经济因素，黑人女性的死亡率要高28%。关于乳腺癌筛查建议依从性的种族差异的现有研究结果相互矛盾。
方法
数据来自1992年全国健康访谈调查，这是一项具有全国代表性的基于人群的抽样调查，涉及4500多名女性。采用逻辑回归来估计乳房自我检查（BSE）和乳房X光检查知识的相对几率，以及BSE、临床乳房检查（CBE）和乳房X光检查的依从性。
结果
黑人女性比白人女性更不可能知晓并使用乳腺癌筛查测试。然而，在知晓筛查测试的女性中，黑人女性的依从性更高。教育程度低、癌症知识少且没有固定医疗保健来源的女性进行CBE或乳房X光检查的可能性较小。两项临床检查的社会经济差异比BSE更大。
结论
项目应告知女性癌症筛查测试的相关信息，并消除阻碍女性接受临床筛查检查的障碍。
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