Department of Medicine, University of Florida College of Medicine, Jacksonville, Florida 32209, USA.
J Natl Med Assoc. 2010 Mar;102(3):206-18. doi: 10.1016/s0027-9684(15)30527-7.
The purpose of this review was to better understand possible social, economic, cultural, behavioral, and systems barriers to breast cancer screening among minority women.
Relevant manuscripts were identified through a MEDLINE/PubMed search for English-language literature from October 1971 through April 2009. The abstracts from a total of 515 manuscripts were reviewed. Only studies conducted among minority women in the United States and examining barriers related to screening mammography were considered. Of 64 relevant articles, 13 cross-sectional and 4 prospective studies met inclusion criteria. Study design; patient characteristics; outcomes regarding knowledge, attitudes and beliefs; social norms; accessibility; and cultural competence regarding breast cancer screening were abstracted. Studies were rated using a methodological quality score (MQS).
Pain and embarrassment associated with screening mammography, low income and lack of health insurance, poor knowledge about breast cancer screening, lack of physician recommendation, lack of trust in hospitals and doctors, language barriers, and lack of transportation were the most frequently identified barriers. The average MQS of the studies selected was 10.9 (SD = 3.25, range, 4-20).
Multiple barriers limit screening mammography among minority women. Recognizing predictors of screening among minority women and addressing culturally specific barriers may improve utilization of screening mammography among these women.
本研究旨在更好地理解少数族裔妇女进行乳腺癌筛查时可能存在的社会、经济、文化、行为和系统障碍。
通过 MEDLINE/PubMed 搜索，从 1971 年 10 月至 2009 年 4 月，获取英文文献，以确定相关文献。共对 515 篇文献的摘要进行了评估，仅考虑了在美国进行的、与筛查乳房 X 线摄影相关的少数民族妇女研究。在 64 篇相关文章中，有 13 项横断面研究和 4 项前瞻性研究符合纳入标准。提取了研究设计、患者特征、关于知识、态度和信念、社会规范、可及性以及乳腺癌筛查方面的文化能力等方面的结果。使用方法学质量评分（MQS）对研究进行了评估。
与筛查乳房 X 线摄影相关的疼痛和尴尬、低收入和缺乏健康保险、对乳腺癌筛查的知识不足、缺乏医生推荐、对医院和医生的信任度低、语言障碍以及缺乏交通工具是最常被识别出的障碍。入选研究的平均 MQS 为 10.9（SD=3.25，范围为 4-20）。
多种障碍限制了少数族裔妇女进行乳房 X 线筛查。识别少数民族妇女筛查的预测因素并解决特定于文化的障碍，可能会提高这些妇女对筛查乳房 X 线摄影的利用率。
