Desjeux Guillaume, Aspar Anne-Marie, d'Istria Emilie Colonna, Raude Danielle, Audet-Lapointe Michel, Balaire Corinne, Codaccioni Alain
Unité d'expertise en santé publique, Département des services médicaux, Caisse nationale militaire de sécurité sociale, F-83090 Toulon Cedex 9, France.
Presse Med. 2008 Sep;37(9):1205-11. doi: 10.1016/j.lpm.2007.12.010. Epub 2008 Mar 25.
An officially-sponsored and free breast cancer screening in France was extended to all regions in 2004. These mammography procedures include double reading, which reduces the number of false negatives. Together with this official program, administered by associations in each district, voluntary individual screening is still available. The aim of this study is to ascertain what women think about breast cancer screening, why they choose one method of screening or the other, and what they know about "double reading".
A postal survey inquiring about the kind of screening chosen and the reasons for this choice was sent to women aged 50 to 74 years covered by the national military health insurance fund. After descriptive analysis of the results, we compared the respondents' knowledge of double reading according to residence (two departments, one rural one and one urban), age, and educational level.
541 of the 994 eligible women responded (54%). More than 94% of them had had a mammography within the past two years, 62.1% through the official program. Women who had participated in the official screening knew more about "double reading" than the others (71.6% versus 50%, p<0.05 in the rural district and 67.4% versus 63.9% in the urban district). In the latter, familiarity with double reading increased as age decreased. Individual mammography depended on prior habits and gynecologists' prescriptions.
Women must shift from individual mammography to the official program to receive a standardized, double-read, and quality-controlled mammography. Prescribing physicians should serve as an additional entryway into the organized program.
法国一项官方资助的免费乳腺癌筛查项目于2004年扩展至所有地区。这些乳房X光检查程序包括双人阅片，可减少假阴性数量。除了由各地区协会管理的这个官方项目外，自愿的个人筛查仍然可行。本研究的目的是确定女性对乳腺癌筛查的看法、她们选择一种筛查方法而非另一种的原因，以及她们对“双人阅片”的了解程度。
向国家军事医疗保险基金覆盖的50至74岁女性发送了一份邮政调查问卷，询问她们选择的筛查类型及选择原因。在对结果进行描述性分析后，我们根据居住地区（两个部门，一个农村地区和一个城市地区）、年龄和教育水平比较了受访者对双人阅片的了解情况。
994名符合条件的女性中有541人回复（54%）。其中超过94%的人在过去两年内进行过乳房X光检查，62.1%是通过官方项目进行的。参加官方筛查的女性比其他人对“双人阅片”了解更多（农村地区为71.6%对50%，p<0.05；城市地区为67.4%对63.9%）。在城市地区，对双人阅片的熟悉程度随着年龄的降低而增加。个人乳房X光检查取决于既往习惯和妇科医生的处方。
女性必须从个人乳房X光检查转向官方项目，以接受标准化、双人阅片且质量可控的乳房X光检查。开处方的医生应作为进入有组织项目的另一个途径。
