Breen Nancy, Yabroff K Robin, Meissner Helen I
Health Services and Economics Branch, Applied Research Program, Division of Cancer Control and Population Sciences, National Cancer Institute, EPN 4005, 6130 Executive Boulevard, MSC 7344, Rockville, MD 20852-7344, USA.
Cancer Detect Prev. 2007;31(3):220-4. doi: 10.1016/j.cdp.2007.04.006. Epub 2007 Jun 15.
None of the recent national studies has ascertained how women's breast cancer was detected in the United States. To rectify this gap, questions were added to the leading national health survey. Mammography was of special interest because it is widely used in the US and has evidence of a mortality benefit.
We used the 2003 National Health Interview Survey (NHIS), to ascertain the self-reported modalities used to detect breast cancer in the non-institutionalized US population. The study included 345 women 40-84 years of age who, in 2003, reported a personal history of breast cancer. We examined the frequency of self-reported characteristics and tested for association with mammography-detected breast cancer using logistic regression.
Among the survivors in 2003, the percentage of breast cancers detected by mammography was much higher after 2001 (59%) than before 1993 (29%). Breast cancer survivors with less than high school education or less than US$ 20,000 household income were less likely to report detection by mammography.
Women reported mammography-detected breast cancer at a slightly higher rate than published studies of mammography sensitivity and use would suggest. Lower rates of mammography-detected breast cancers among survivors with low income or low education raise the question whether mammography is underutilized as a diagnostic tool, especially for underserved women.
近期的全国性研究均未确定美国女性乳腺癌的检测方式。为填补这一空白，在主要的全国性健康调查中增加了相关问题。乳房X线摄影术备受关注，因为它在美国广泛应用且有降低死亡率的证据。
我们使用2003年全国健康访谈调查（NHIS），以确定美国非机构化人群中自我报告的乳腺癌检测方式。该研究纳入了345名年龄在40 - 84岁之间、在2003年报告有乳腺癌个人病史的女性。我们检查了自我报告特征的频率，并使用逻辑回归测试其与乳房X线摄影术检测到的乳腺癌之间的关联。
在2003年的幸存者中，2001年之后通过乳房X线摄影术检测出的乳腺癌比例（59%）远高于1993年之前（29%）。受教育程度低于高中或家庭收入低于2万美元的乳腺癌幸存者通过乳房X线摄影术检测出癌症的可能性较小。
女性报告通过乳房X线摄影术检测出乳腺癌的比例略高于已发表的关于乳房X线摄影术敏感性和使用情况的研究结果。低收入或低教育水平的幸存者中通过乳房X线摄影术检测出乳腺癌的比例较低，这引发了一个问题，即乳房X线摄影术作为一种诊断工具是否未得到充分利用，尤其是对于服务不足的女性。
