Gomez Scarlett Lin, Tan Susanna, Keegan Theresa H M, Clarke Christina A
Northern California Cancer Center, 2201 Walnut Ave, Suite 300, Fremont, CA, 94538, USA.
BMC Cancer. 2007 Oct 26;7:201. doi: 10.1186/1471-2407-7-201.
BACKGROUND: Breast cancer is the most commonly diagnosed cancer among the rapidly growing population of Asian Americans; it is also the most common cause of cancer mortality among Filipinas. Asian women continue to have lower rates of mammographic screening than women of most other racial/ethnic groups. While prior studies have described the effects of sociodemographic and other characteristics of women on non-adherence to screening guidelines, they have not identified the distinct segments of the population who remain at highest risk of not being screened. METHODS: To better describe characteristics of Asian women associated with not having a mammogram in the last two years, we applied recursive partitioning to population-based data (N = 1521) from the 2001 California Health Interview Survey (CHIS), for seven racial/ethnic groups of interest: Chinese, Japanese, Filipino, Korean, South Asian, Vietnamese, and all Asians combined. RESULTS: We identified two major subgroups of Asian women who reported not having a mammogram in the past two years and therefore, did not follow mammography screening recommendations: 1) women who have never had a pap exam to screen for cervical cancer (68% had no mammogram), and 2) women who have had a pap exam, but have no women's health issues (osteoporosis, using menopausal hormone therapies, and/or hysterectomy) nor a usual source of care (62% had no mammogram). Only 19% of Asian women who have had pap screening and have women's health issues did not have a mammogram in the past two years. In virtually all ethnic subgroups, having had pap or colorectal screening were the strongest delineators of mammography usage. Other characteristics of women least likely to have had a mammogram included: Chinese non-U.S. citizens or citizens without usual source of health care, Filipinas with no health insurance, Koreans without women's health issues and public or no health insurance, South Asians less than age 50 who were unemployed or non-citizens, and Vietnamese women who were never married. CONCLUSION: We identified distinct subgroups of Asian women at highest risk of not adhering to mammography screening guidelines; these data can inform outreach efforts aimed at reducing the disparity in mammography screening among Asian women.
背景：在快速增长的亚裔美国人中，乳腺癌是最常被诊断出的癌症；在菲律宾裔女性中，它也是癌症死亡的最常见原因。亚裔女性进行乳房X光检查筛查的比例持续低于大多数其他种族/族裔群体的女性。虽然先前的研究描述了女性的社会人口学特征和其他特征对不遵守筛查指南的影响，但它们尚未确定仍处于未接受筛查最高风险的不同人群细分。 方法：为了更好地描述与过去两年未进行乳房X光检查相关的亚裔女性特征，我们对来自2001年加利福尼亚健康访谈调查（CHIS）的基于人群的数据（N = 1521）应用递归划分，涉及七个感兴趣的种族/族裔群体：华裔、日裔、菲律宾裔、韩裔、南亚裔、越南裔以及所有亚裔的合并群体。 结果：我们确定了过去两年报告未进行乳房X光检查因此未遵循乳房X光检查筛查建议的两个主要亚组亚裔女性：1）从未进行过子宫颈抹片检查以筛查宫颈癌的女性（68%未进行乳房X光检查），以及2）进行过子宫颈抹片检查但没有女性健康问题（骨质疏松症、使用更年期激素疗法和/或子宫切除术）且没有常规医疗保健来源的女性（62%未进行乳房X光检查）。在过去两年中，只有19%进行过子宫颈抹片检查且有女性健康问题的亚裔女性未进行乳房X光检查。在几乎所有族裔亚组中，进行过子宫颈抹片检查或结肠直肠癌筛查是乳房X光检查使用情况的最强划分因素。最不可能进行过乳房X光检查的女性的其他特征包括：非美国公民或没有常规医疗保健来源的华裔公民、没有医疗保险的菲律宾裔女性、没有女性健康问题且有公共医疗保险或无医疗保险的韩裔女性、年龄小于50岁且失业或非公民的南亚裔女性以及从未结婚的越南裔女性。 结论：我们确定了未遵守乳房X光检查筛查指南风险最高的不同亚组亚裔女性；这些数据可为旨在减少亚裔女性乳房X光检查筛查差异的外展工作提供信息。
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