Sabatino Susan A, Coates Ralph J, Uhler Robert J, Breen Nancy, Tangka Florence, Shaw Kate M
Division of Cancer Prevention and Control, National Centers for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia 30341, USA.
Med Care. 2008 Jul;46(7):692-700. doi: 10.1097/MLR.0b013e31817893b1.
To examine current disparities in mammography use, and changes in disparities over time by race, ethnicity, income, insurance, and combinations of these characteristics.
Comparison of cross-sectional surveys of mammography use using the 1993 and 2005 National Health Interview Survey.
Women aged 40-64 (1993, n = 4167; 2005, n = 7434).
Mammogram within prior 2 years.
In 2005, uninsured women reported the lowest mammography use (38.3%). Though screening increased 6.9 percentage points among low-income, uninsured women, the overall disparity between insured and uninsured women did not change significantly between 1993 and 2005. Screening seems to have declined among middle-income, uninsured women, increasing the gap compared with middle-income, insured women. The lower mammography use in 1993 among American Indian/Alaska Native compared with white women was not present in 2005; however, lower use among Asian compared with white women emerged in 2005. We found no differences between African American and white women. Hispanic women were less likely than non-Hispanic women to report screening in 2005 (58.1% vs. 69.0%).
Although mammography use increased for some groups between 1993 and 2005, low-income, uninsured women continued to have the lowest screening rates in 2005 and the disparity for this group was not reduced. The gap in screening use for middle-income, uninsured women increased, resulting from possible declines in mammography even for uninsured women not in poverty. Asian women became less likely to receive screening in 2005. Continuing efforts are needed to eliminate disparities. Increased efforts are especially needed to address the large persistent disparity for uninsured women, including middle-income uninsured women.
研究当前乳腺钼靶检查使用情况的差异，以及这些差异随时间推移在种族、族裔、收入、保险状况以及这些特征组合方面的变化。
使用1993年和2005年全国健康访谈调查对乳腺钼靶检查使用情况的横断面调查进行比较。
40 - 64岁女性（1993年，n = 4167；2005年，n = 7434）。
过去两年内进行过乳腺钼靶检查。
2005年，未参保女性的乳腺钼靶检查使用率最低（38.3%）。尽管低收入未参保女性的筛查率提高了6.9个百分点，但1993年至2005年期间，参保女性和未参保女性之间的总体差异没有显著变化。中等收入未参保女性的筛查率似乎有所下降，与中等收入参保女性相比差距增大。1993年美国印第安/阿拉斯加原住民女性的乳腺钼靶检查使用率低于白人女性，2005年这种情况不存在了；然而，2005年亚洲女性与白人女性相比使用率较低的情况出现了。我们发现非裔美国女性和白人女性之间没有差异。2005年，西班牙裔女性报告进行筛查的可能性低于非西班牙裔女性（58.1%对69.0%）。
尽管1993年至2005年期间一些群体的乳腺钼靶检查使用率有所提高，但2005年低收入未参保女性的筛查率仍然最低，且该群体的差异没有缩小。中等收入未参保女性的筛查使用差距增大，这可能是由于即使是非贫困未参保女性的乳腺钼靶检查率也可能下降。2005年亚洲女性接受筛查的可能性降低。需要持续努力消除差异。尤其需要加大力度解决未参保女性，包括中等收入未参保女性存在的巨大且持续的差异。
