Gierisch Jennifer M, O'Neill Suzanne C, Rimer Barbara K, DeFrank Jessica T, Bowling J Michael, Skinner Celette Sugg
Department of General Internal Medicine, Duke University Medical Center, Durham, NC 27707, USA.
Cancer Epidemiol. 2009 Jul;33(1):72-8. doi: 10.1016/j.cdp.2009.03.001. Epub 2009 May 29.
Evidence is mounting that annual mammography for women in their 40s may be the optimal schedule to reduce morbidity and mortality from breast cancer. Few studies have assessed predictors of repeat mammography on an annual interval among these women.
We assessed mammography screening status among 596 insured Black and Non-Hispanic white women ages 43-49. Adherence was defined as having a second mammogram 10-14 months after a previous mammogram. We examined socio-demographic, medical and healthcare-related variables on receipt of annual-interval repeat mammograms. We also assessed barriers associated with screening.
44.8% of the sample were adherent to annual-interval mammography. A history of self-reported abnormal mammograms, family history of breast cancer and never having smoked were associated with adherence. Saying they had not received mammography reminders and reporting barriers to mammography were associated with non-adherence. Four barrier categories were associated with women's non-adherence: lack of knowledge/not thinking mammograms are needed, cost, being too busy, and forgetting to make/keep appointments.
Barriers we identified are similar to those found in other studies. Health professionals may need to take extra care in discussing mammography screening risk and benefits due to ambiguity about screening guidelines for women in their 40s, especially for women without family histories of breast cancer or histories of abnormal mammograms. Reminders are important in promoting mammography and should be coupled with other strategies to help women maintain adherence to regular mammography.
越来越多的证据表明,40多岁女性每年进行乳腺钼靶检查可能是降低乳腺癌发病率和死亡率的最佳方案。很少有研究评估这些女性每年定期进行乳腺钼靶复查的预测因素。
我们评估了596名年龄在43 - 49岁的有保险的黑人及非西班牙裔白人女性的乳腺钼靶筛查状况。依从性定义为在上次乳腺钼靶检查后10 - 14个月进行第二次乳腺钼靶检查。我们研究了接受年度复查乳腺钼靶检查时的社会人口统计学、医疗和医疗保健相关变量。我们还评估了与筛查相关的障碍。
44.8%的样本坚持每年进行乳腺钼靶检查。自我报告的乳腺钼靶异常病史、乳腺癌家族史以及从不吸烟与依从性相关。表示未收到乳腺钼靶检查提醒以及报告乳腺钼靶检查存在障碍与不依从性相关。四类障碍与女性的不依从性相关:缺乏知识/认为不需要进行乳腺钼靶检查、费用、太忙以及忘记预约/爽约。
我们确定的障碍与其他研究中发现的障碍相似。由于40多岁女性的筛查指南存在模糊性,尤其是对于没有乳腺癌家族史或乳腺钼靶异常病史的女性,健康专业人员在讨论乳腺钼靶筛查的风险和益处时可能需要格外小心。提醒在促进乳腺钼靶检查方面很重要,并且应该与其他策略相结合,以帮助女性保持定期进行乳腺钼靶检查的依从性。