Department of Family Medicine, Department of Epidemiology and Biostatistics, Schulich School of Medicine, University of Western Ontario, Canada.
J Womens Health (Larchmt). 2009 Nov;18(11):1807-11. doi: 10.1089/jwh.2008.1224.
Breast cancer is the most common malignancy among women, and its timely diagnosis and treatment are of paramount importance, especially for vulnerable groups, such as low-income and uninsured women. Recent literature confirms that the method of breast cancer detection may be an important prognostic factor, but there are no studies that examine the method of breast cancer detection in low-income populations. We sought to analyze the determinants of method of detection (medical vs. self) in a cohort of low-income women with breast cancer receiving care through California's Breast and Cervical Cancer Treatment Program.
This is a cross-sectional survey analysis of 921 low-income women interviewed within 6 months of definitive surgical treatment. The outcome analyzed was self vs. medical detection of breast cancer.
The mean age of the women was 53 years, with nearly 88% reporting an income of <$30,000 per year; 64% of women self-detected their breast cancer. Logistic regression analyses revealed that older women, Latinas, and women having any health insurance before diagnosis had lower odds of self-detecting their lesions.
Patient age, ethnicity, and regular source of care were associated with method of breast cancer detection in a low-income underserved population. The rate of self-detection in our population correlates with the literature, but we need to improve efforts to increase mammography screening to ensure early detection of disease in this vulnerable group.
乳腺癌是女性中最常见的恶性肿瘤,及时诊断和治疗至关重要,特别是对于低收入和没有保险的女性等弱势群体。最近的文献证实,乳腺癌的检测方法可能是一个重要的预后因素,但没有研究检查低收入人群中乳腺癌的检测方法。我们试图通过加利福尼亚州的乳腺癌和宫颈癌治疗计划来分析接受治疗的低收入乳腺癌女性队列中检测方法(医疗与自我)的决定因素。
这是对 921 名在明确手术治疗后 6 个月内接受采访的低收入女性进行的横断面调查分析。分析的结果是自我与医疗检测乳腺癌。
女性的平均年龄为 53 岁,近 88%的女性报告年收入<30,000 美元;64%的女性自我发现了乳腺癌。逻辑回归分析显示,年龄较大的女性、拉丁裔女性和诊断前有任何医疗保险的女性自我发现病变的可能性较低。
患者年龄、种族和常规护理来源与低收入服务不足人群中的乳腺癌检测方法相关。我们人群中的自我检测率与文献相符,但我们需要加强努力,增加乳房 X 光筛查,以确保这一弱势群体及早发现疾病。