Goodwin Susan S, Visintainer Paul F, Facelle Joan, Falvo Cathey E
Department of Environmental Health Sciences, School of Public Health, New York Medical College, Valhalla 10595, USA.
Ethn Dis. 2006 Spring;16(2):428-34.
Higher-than-average breast cancer incidence and mortality rates in Rockland County (NY) may be explained by higher screening rates, but screening frequency has not been measured at the county level. This study was conducted to determine adherence to breast cancer screening guidelines in Rockland, and whether adherence differs by ethnicity, age, educational level, insurance status, and race.
A telephone survey of screening behaviors and attitudes was administered to a random sample of Rockland County women age > or = 40 years. Prevalence estimates of mammography, clinical breast exam (CBE), and breast self-examination (BSE) were derived by using exact confidence intervals (CIs) for proportions. Differences in demographic groups were assessed with chi-square tests and 95% CIs. Logistic regression was used to determine independent contributions of demographic characteristics after adjustment.
Overall, 76.4% of respondents received a mammogram and CBE in the past year, compared with 60.3% in New York State and 55.5% in the United States. Significant predictors of a mammogram in the past year were age, education, marital status, and health insurance; of CBE in the past year were age, education, and marital status; of BSE at least monthly was marital status. Being Jewish was associated with a mammogram and CBE in the past year but did not attain significance (P = .06 and .08, respectively).
Mammography and CBE usage in Rockland County appear to exceed that of New York State and the United States. The county health department can target relevant demographic subgroups for health education programs.
纽约州罗克兰县高于平均水平的乳腺癌发病率和死亡率可能是由于筛查率较高，但尚未在县一级对筛查频率进行测量。本研究旨在确定罗克兰县对乳腺癌筛查指南的遵守情况，以及遵守情况是否因种族、年龄、教育水平、保险状况和种族而有所不同。
对罗克兰县年龄≥40岁的女性随机样本进行了关于筛查行为和态度的电话调查。通过使用比例的精确置信区间（CI）得出乳房X线摄影、临床乳腺检查（CBE）和乳房自我检查（BSE）的患病率估计值。使用卡方检验和95%CI评估人口统计学组之间的差异。调整后，使用逻辑回归来确定人口统计学特征的独立贡献。
总体而言，76.4%的受访者在过去一年接受了乳房X线摄影和CBE，相比之下，纽约州为60.3%，美国为55.5%。过去一年进行乳房X线摄影的显著预测因素是年龄、教育程度、婚姻状况和健康保险；过去一年进行CBE的显著预测因素是年龄、教育程度和婚姻状况；至少每月进行一次BSE的显著预测因素是婚姻状况。犹太人与过去一年进行乳房X线摄影和CBE有关，但未达到显著水平（P分别为0.06和0.08）。
罗克兰县的乳房X线摄影和CBE使用率似乎超过了纽约州和美国。县卫生部门可以针对相关的人口统计学亚组开展健康教育项目。
