乳房X光检查异常后随访时间的种族/民族差异。

Racial/ethnic disparities in time to follow-up after an abnormal mammogram.

作者信息

Press Rebecca, Carrasquillo Olveen, Sciacca Robert R, Giardina Elsa-Grace V

机构信息

Division of General Medicine, Department of Medicine, Columbia University Medical Center, College of Physicians and Surgeons, New York, New York, USA.

出版信息

J Womens Health (Larchmt). 2008 Jul-Aug;17(6):923-30. doi: 10.1089/jwh.2007.0402.

Abstract

BACKGROUND

Although non-Hispanic white women have an increased risk of developing breast cancer, the disease-specific survival is lower for African American and Hispanic women. Little is known about disparities in follow-up after an abnormal mammogram. The goal of this study was to investigate potential disparities in follow-up after an abnormal mammogram.

METHODS

A retrospective cohort study of 6722 women with an abnormal mammogram and documented follow-up from January 2000 through December 2002 was performed at an academic medical center in New York City. The outcome was the number of days between the abnormal mammogram and follow-up imaging or biopsy. Cox proportional hazards models were used to assess the effect of race/ethnicity and other potential covariates.

RESULTS

The median number of days to diagnostic follow-up after an abnormal mammogram was greater for African American (20 days) and Hispanic (21 days) women compared with non-Hispanic white (14 days) women (p < 0.001). Racial/ethnic disparities remained significant in a multivariable model controlling for age, Breast Imaging Reporting and Data System (BIRADS) category, insurance status, provider practice location, and median household income.

CONCLUSIONS

After an abnormal mammogram, African American and Hispanic women had longer times to diagnostic follow-up compared with non-Hispanic white women. Future efforts will focus on identifying the barriers to follow-up so that effective interventions may be implemented.

摘要

背景

尽管非西班牙裔白人女性患乳腺癌的风险增加,但非裔美国人和西班牙裔女性的特定疾病生存率较低。对于乳房X光检查异常后的随访差异知之甚少。本研究的目的是调查乳房X光检查异常后的潜在随访差异。

方法

在纽约市的一家学术医疗中心对6722名乳房X光检查异常且有记录随访情况的女性进行了一项回顾性队列研究,研究时间为2000年1月至2002年12月。观察指标是乳房X光检查异常与后续成像或活检之间的天数。使用Cox比例风险模型评估种族/族裔和其他潜在协变量的影响。

结果

与非西班牙裔白人女性(14天)相比,非裔美国女性(20天)和西班牙裔女性(21天)在乳房X光检查异常后进行诊断性随访的天数中位数更长(p < 0.001)。在控制了年龄、乳房影像报告和数据系统(BIRADS)分类、保险状况、医疗服务提供者执业地点和家庭收入中位数的多变量模型中,种族/族裔差异仍然显著。

结论

乳房X光检查异常后,非裔美国女性和西班牙裔女性进行诊断性随访的时间比非西班牙裔白人女性更长。未来的工作将集中在确定随访的障碍,以便实施有效的干预措施。

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