Department of Family and Community Medicine, University of Missouri, MA306 Medical Sciences Bldg, 1 Hospital Drive, Columbia, MO 65212, USA.
Cancer Epidemiol Biomarkers Prev. 2011 Apr;20(4):600-8. doi: 10.1158/1055-9965.EPI-10-1070. Epub 2011 Jan 17.
Twenty-nine percent of women, aged 30 to 39, report having had a mammogram, though sensitivity and specificity are low. We investigate racial/ethnic differences in future mammography behavior among women who had a baseline screening mammogram prior to age 40.
Using 1994-2008 data from the Breast Cancer Surveillance Consortium (BCSC), we identified 29,390 women aged 35 to 39 with a baseline screening mammogram. We followed this cohort for 2 outcomes: (i) future BCSC mammography between ages 40 and 45; and (2) among those, delay in screening mammography until ages 43 to 45 compared with ages 40 to 42. Using adjusted log-linear models, we estimated the relative risk (RR) of these outcomes by race/ethnicity, while also considering the impact of false-positive/true-negative (FP/TN) baseline mammography results on these outcomes.
Relative to non-Hispanic white women, Hispanic women had an increased risk of no future BCSC mammography (RR: 1.21, 95% CI: 1.13-1.30); Asian women had a decreased risk (RR: 0.67, 95% CI: 0.61-0.74). Women with a FP result, compared with a TN result, had a decreased risk of no future BCSC mammography (RR: 0.89, 95% CI: 0.85-0.95). Among those with future BCSC screening mammography, African American women were more likely to delay the timing (RR: 1.26, 95% CI: 1.09-1.45). The interaction between race/ethnicity and FP/TN baseline results was not significant.
Race/ethnicity is differentially associated with future BCSC mammography and the timing of screening mammography after age 40.
These findings introduce the need for research that examines disparities in lifetime mammography use patterns from the initiation of mammography screening.
30 岁至 39 岁的女性中，有 29%曾接受过乳房 X 光检查，但敏感性和特异性都较低。我们调查了在 40 岁之前接受过基线筛查性乳房 X 光检查的女性中，未来乳房 X 光检查行为的种族/民族差异。
使用 1994 年至 2008 年期间乳腺癌监测联合会（BCSC）的数据，我们确定了 29390 名年龄在 35 岁至 39 岁之间基线筛查性乳房 X 光检查的女性。我们对这一队列进行了 2 种结果的随访：（i）40 岁至 45 岁之间的 BCSC 乳房 X 光检查；（ii）在这些女性中，与 40 岁至 42 岁相比，延迟至 43 岁至 45 岁进行筛查性乳房 X 光检查。使用调整后的对数线性模型，我们根据种族/民族估算了这些结果的相对风险（RR），同时还考虑了假阳性/真阴性（FP/TN）基线乳房 X 光检查结果对这些结果的影响。
与非西班牙裔白人女性相比，西班牙裔女性未来 BCSC 乳房 X 光检查的风险增加（RR：1.21，95%CI：1.13-1.30）；亚洲女性的风险降低（RR：0.67，95%CI：0.61-0.74）。与 TN 结果相比，FP 结果的女性未来接受 BCSC 乳房 X 光检查的风险降低（RR：0.89，95%CI：0.85-0.95）。在那些未来接受 BCSC 筛查性乳房 X 光检查的女性中，非洲裔美国女性更有可能延迟检查时间（RR：1.26，95%CI：1.09-1.45）。种族/民族与 FP/TN 基线结果之间的交互作用不显著。
种族/民族与未来 BCSC 乳房 X 光检查以及 40 岁后筛查性乳房 X 光检查的时间有关。
这些发现表明，需要研究从开始接受乳房 X 光检查开始，分析终生乳房 X 光检查使用模式的差异。
