Whitman Steve, Shah Ami M, Silva Abigail, Ansell David
Urban Health Institute, Sinai Health System, 1500 South California Avenue, Chicago, IL 60608, USA.
Cancer Detect Prev. 2007;31(2):166-72. doi: 10.1016/j.cdp.2006.12.008. Epub 2007 Apr 6.
Despite the fact that recent studies suggest a narrowing in access to mammography, Black women are much more likely to die from breast cancer than White women. Data at the community level regarding mammography screening can help explain health disparities and inform plans for improved screening efforts.
In 2002-2003, a comprehensive household health survey in English or Spanish was conducted in six community areas with 1700 households. The module on mammography was based on a state-based nationwide health survey and included questions on frequency of mammography, repeat screenings, and several demographic variables.
The proportion of women >or=40 years (n=482) who received a mammogram in the past 2 years ranged from 74% to 90% across the six communities. The community with the highest screening proportion was predominantly Mexican and included recent immigrants. The screening proportion in the poorest community area, which was all Black, was 77%. Women with health insurance, higher income, and more education were more likely to receive a mammogram. Proportions for women >or=50 years (n=286) were slightly higher but similar. Repeat screening, which is recommended, occurred at lower levels.
Access to and utilization of mammography have grown in recent years so that even these vulnerable communities had screening proportions at or even higher than the national average and the Healthy People Year 2010 objective. Nonetheless, repeat screening sequences were lower and may require attention if mammography screening efforts are to have a greater impact on female breast cancer mortality.
尽管近期研究表明乳房X光检查的可及性有所缩小，但黑人女性死于乳腺癌的可能性远高于白人女性。社区层面有关乳房X光检查筛查的数据有助于解释健康差异，并为改进筛查工作的计划提供信息。
2002年至2003年，在六个社区地区对1700户家庭进行了一项用英语或西班牙语进行的全面家庭健康调查。乳房X光检查模块基于一项全国性的州级健康调查，包括有关乳房X光检查频率、重复筛查以及若干人口统计学变量的问题。
在六个社区中，年龄≥40岁（n = 482）的女性在过去两年接受乳房X光检查的比例在74%至90%之间。筛查比例最高的社区主要是墨西哥人社区，包括新移民。最贫困的全黑人社区的筛查比例为77%。有医疗保险、收入较高且受教育程度较高的女性更有可能接受乳房X光检查。年龄≥50岁（n = 286）的女性的比例略高但情况类似。推荐的重复筛查比例较低。
近年来乳房X光检查的可及性和利用率有所提高，因此即使是这些弱势群体社区的筛查比例也达到或甚至高于全国平均水平以及《2010年健康人群》目标。尽管如此，重复筛查比例较低，如果乳房X光检查筛查工作要对女性乳腺癌死亡率产生更大影响，可能需要予以关注。
