Duport Nicolas, Ancelle-Park Rosemary
Institut de Veille Sanitaire, Département des Maladies Chroniques et des Traumatismes, Saint-Maurice, France.
Eur J Cancer Prev. 2006 Jun;15(3):219-24. doi: 10.1097/01.cej.0000198902.78420.de.
The aim of this study was to analyse the independent role of socio-demographic factors on the use of mammography according to whether or not an organized breast cancer screening programme exists. The study sample of 2825 women aged 40-74 years was drawn from a cross-sectional population-based survey of French households. Among these women 46% lived in districts that offered a screening programme and 63% reported undergoing mammography in the previous 2 years. Living in a district that offered a screening programme was associated with increased use of mammography. According to both univariate and multivariate analysis, several socio-demographic characteristics, such as high monthly household income or high education level, increased the probability of using mammography. However, three factors had a major positive impact on its use: (1) having had a gynaecological examination in the previous 2 years, (2) living in a district where a screening programme was available, and (3) age. There was a significant interaction between the factors 2 and 3. Between 40 and 60 years, age had the same impact on the use of mammography whether or not women lived in a district with a screening programme. After the age of 60 years, the use of mammography collapsed among women living in a district without a screening programme and remained frequent among women living in the district that offered such a programme. Even if the overall level of mammography screening was high and the existence of a screening programme maintained a high level of mammography use among older women, the programme should target better the women of underprivileged spheres and reinforce the role of the general practitioner; in particular for women not followed by a gynaecologist.
本研究的目的是根据是否存在有组织的乳腺癌筛查项目，分析社会人口学因素对乳房X光检查使用情况的独立作用。该研究样本来自对法国家庭进行的基于人群的横断面调查，共2825名年龄在40 - 74岁的女性。在这些女性中，46%生活在提供筛查项目的地区，63%报告在过去两年内接受过乳房X光检查。生活在提供筛查项目的地区与乳房X光检查使用率的增加有关。根据单变量和多变量分析，一些社会人口学特征，如家庭月收入高或教育水平高，会增加进行乳房X光检查的可能性。然而，有三个因素对其使用有重大的积极影响：（1）在过去两年内进行过妇科检查；（2）生活在有筛查项目的地区；（3）年龄。因素2和3之间存在显著的相互作用。在40至60岁之间，无论女性是否生活在有筛查项目的地区，年龄对乳房X光检查使用情况的影响相同。60岁以后，生活在没有筛查项目地区的女性乳房X光检查使用率大幅下降，而生活在提供该项目地区的女性使用率仍然很高。即使乳房X光检查的总体水平较高，且筛查项目的存在使老年女性的乳房X光检查使用率保持在较高水平，但该项目仍应更好地针对弱势群体的女性，并加强全科医生的作用；特别是对于没有妇科医生随访的女性。
