Boudreau Denise M, Luce Casey L, Ludman Evette, Bonomi Amy E, Fishman Paul A
Group Health Center for Health Studies, Seattle, WA 98101, USA.
Prev Med. 2007 Oct;45(4):262-6. doi: 10.1016/j.ypmed.2007.07.011. Epub 2007 Jul 17.
Estimates of adherence to mammography screening guidelines vary, in part, due to lack of consensus on defining adherence. This study estimated adherence to repeat (two successive on-time screenings) and regular screening (three or more successive screenings) and evaluated the impact of varying operational definitions and evaluation periods.
The study included women aged 50-80 without a history of breast cancer who: were on a biennial screening cycle and due for a screening mammogram between 1995 and 1996; underwent screening (index date) in response to a reminder letter; and belonged to Group Health, an integrated health care delivery system in Washington State, for 6 or more years after the index date. Automated records provided information on enrollment, health care utilization, and procedures.
Among 1336 women, 67-82% experienced a repeat screen. Adherence to regular screening over the 6-year evaluation period was 42-84%--and higher with longer allowable intervals between screenings, when definitions did not require on-schedule screenings, when intervals were reset after a diagnostic mammogram, and for shorter evaluation periods.
Estimates of adherence to screening guidelines varied by the operational definition of "success" and time period of evaluation. Consensus in definitions and terminology is needed to compare evaluations.
对乳腺钼靶筛查指南依从性的估计各不相同，部分原因是在定义依从性方面缺乏共识。本研究估计了重复筛查（两次连续按时筛查）和定期筛查（三次或更多次连续筛查）的依从性，并评估了不同操作定义和评估期的影响。
该研究纳入了年龄在50 - 80岁且无乳腺癌病史的女性，这些女性：处于两年一次的筛查周期，在1995年至1996年期间应进行乳腺钼靶筛查；因收到提醒信而接受筛查（索引日期）；在索引日期后属于华盛顿州的一个综合医疗保健系统“Group Health”达6年或更长时间。自动化记录提供了有关登记、医疗保健利用和程序的信息。
在1336名女性中，67 - 82%进行了重复筛查。在6年评估期内，定期筛查的依从性为42 - 84%，当筛查间隔允许更长时间、定义不要求按时筛查、在诊断性乳腺钼靶检查后重置间隔以及评估期较短时，依从性更高。
对筛查指南依从性的估计因“成功”的操作定义和评估时间段而异。需要在定义和术语上达成共识以比较评估结果。
