国家乳腺癌和宫颈癌早期检测项目中的定期乳房X光复查

On-schedule mammography rescreening in the National Breast and Cervical Cancer Early Detection Program.

作者信息

Bobo Janet Kay, Shapiro Jean A, Schulman Jane, Wolters Charles L

机构信息

Division of Cancer Prevention and Control, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA, USA.

出版信息

Cancer Epidemiol Biomarkers Prev. 2004 Apr;13(4):620-30.

PMID:15066928

Abstract

OBJECTIVE

The National Breast and Cervical Cancer Early Detection Program (NBCCEDP) provides free cancer screening to many low-income, underinsured women annually but does not routinely collect all data necessary for precise estimation of mammography rescreening rates among enrollees.

MATERIALS AND METHODS

To determine the percentages rescreened and to identify factors that encourage on-schedule rescreening, telephone interview and medical record data were collected from 1685 enrollees in Maryland, New York, Ohio, and Texas at least 30 months after their 1997 index mammogram.

RESULTS

Overall, 72.4% [95% confidence interval (95% CI) = 70.1-74.7] were rescreened within 18 months and 81.5% (95% CI = 79.6-83.5) within 30 months. At 30 months, the adjusted odds ratios (ORs) for rescreening were higher among Hispanics (OR = 1.95, 95% CI = 1.15-3.28), women with a history of breast cancer before the index mammogram (OR = 3.36, 95% CI = 1.07-10.53), and those who had used hormone replacement therapy before their index mammogram (OR =1.94, 95% CI = 1.30-2.91). The 30-month adjusted ORs were lower for women who reported poor health status (OR = 0.60, 95% CI = 0.42-0.85), did not have a usual source of care (OR = 0.61, 95% CI = 0.40-0.94), did not know if they could have another free mammogram (OR = 0.28, 95% CI = 0.14-0.51), described their index screen as their first mammogram ever (OR for no prior mammograms versus three or more = 0.40, 95% CI = 0.27-0.60), did not recall receiving a rescreening reminder (OR = 0.35, 95% CI = 0.25-0.48), or did not think they had been encouraged to rescreen by their provider (OR = 0.61, 95% CI = 0.44-0.86).

DISCUSSION

Rescreening behavior in this sample of NBCCEDP enrollees was comparable with that observed in other populations. To facilitate routine rescreening among low-income women, ongoing efforts are needed to ensure that they receive annual reminders and encouragements from their medical providers and that they know how to obtain the services they need.

摘要

目的

国家乳腺癌和宫颈癌早期检测项目（NBCCEDP）每年为许多低收入、未充分参保的女性提供免费癌症筛查，但并未常规收集精确估算参保者乳房X线复查率所需的所有数据。

材料与方法

为确定复查百分比并识别鼓励按时复查的因素，在1997年首次乳房X线检查至少30个月后，从马里兰州、纽约州、俄亥俄州和得克萨斯州的1685名参保者处收集了电话访谈和病历数据。

结果

总体而言，72.4%[95%置信区间（95%CI）=70.1 - 74.7]在18个月内接受了复查，81.5%（95%CI = 79.6 - 83.5）在30个月内接受了复查。在30个月时，西班牙裔（比值比[OR]=1.95，95%CI = 1.15 - 3.28）、在首次乳房X线检查前有乳腺癌病史的女性（OR = 3.36，95%CI = 1.07 - 10.53）以及在首次乳房X线检查前使用过激素替代疗法的女性（OR = 1.94，95%CI = 1.30 - 2.91）复查的校正比值比更高。报告健康状况差的女性（OR = 0.60，95%CI = 0.42 - 0.85）、没有固定医疗服务来源的女性（OR = 0.61，95%CI = 0.40 - 0.94）、不知道自己是否还能获得一次免费乳房X线检查的女性（OR = 0.28，95%CI = 0.14 - 0.51）、称其首次筛查为其有史以来第一次乳房X线检查的女性（无既往乳房X线检查与三次或更多次既往检查相比的OR = 0.40，95%CI = 0.27 - 0.60）、不记得收到复查提醒的女性（OR = 0.35，95%CI = 0.25 - 0.48）或认为其医疗服务提供者未鼓励其复查的女性（OR = 0.61，95%CI = 0.44 - 0.86），其30个月时的校正OR较低。