Health Services and Economics Branch, Applied Research Program, Division of Cancer Control and Population Studies, National Cancer Institute, National Institutes of Health, Rockville, Maryland, USA.
Cancer. 2011 May 15;117(10):2209-18. doi: 10.1002/cncr.25679. Epub 2010 Nov 30.
Mammography screening allows for the early detection of breast cancer, which helps reduce mortality from breast cancer, especially in women aged 50 to 69 years. For this report, the authors updated a previous analysis of trends in mammography using newly available data from the National Health Interview Survey (NHIS).
NHIS data from 2008 were used to update trends in rates of US women who had a mammogram within the 2 years before their interview, and 2 methods of calculating rates were compared. The authors focused particularly on the 2000, 2005, and 2008 mammography rates for women aged ≥ 40 years, 40 to 49 years, 50 to 64 years, and ≥ 65 years according to selected sociodemographic and healthcare access characteristics.
For women aged 50 to 64 years and ≥ 65 years, the patterns were similar: Rates rose rapidly from 1987 to 2000, declined, or were stable and then declined, from 2000 to 2005, and increased from 2005 to 2008. Rates for women aged 40 to 49 years rose rapidly from 1987 to 1992 and were relatively stable through 2008. There were large increases in mammography rates among immigrants who had been in the United States for <10 years, non-Hispanic Asian women, and women aged ≥ 65 years who were without ambulatory care insurance.
Overall, mammography rates did not continue to decline between 2005 and 2008. Even so, in 2008, the percentage of women aged ≥ 40 years who had a recent mammogram fell below the Healthy People 2010 objective of 70%, which was met in 2000. However, women aged 50 to 64 years exceeded the Healthy People objective in 2000, 2005, and 2008; and some groups with very low mammography rates currently are catching up. These are important public health achievements.
乳房 X 光筛查可早期发现乳腺癌,有助于降低乳腺癌死亡率,尤其对 50 至 69 岁的女性而言。本报告的作者使用国家健康访谈调查(NHIS)新获得的数据,更新了之前对乳房 X 光检查趋势的分析。
使用 2008 年的 NHIS 数据,更新了在接受采访前 2 年内接受乳房 X 光检查的美国女性的比率趋势,并比较了 2 种计算比率的方法。作者特别关注了根据特定社会人口学和医疗保健获取特征,对 40 岁以上、40 至 49 岁、50 至 64 岁和 65 岁以上的女性在 2000 年、2005 年和 2008 年的乳房 X 光检查率。
对于 50 至 64 岁和 65 岁以上的女性,模式相似:从 1987 年到 2000 年,比率迅速上升,从 2000 年到 2005 年,比率下降或保持稳定,然后下降,从 2005 年到 2008 年,比率上升。从 1987 年到 1992 年,40 至 49 岁女性的乳房 X 光检查率迅速上升,到 2008 年基本保持稳定。在美国居住不到 10 年的移民、非西班牙裔亚裔女性以及没有流动医疗保健保险的 65 岁以上女性的乳房 X 光检查率大幅上升。
总体而言,2005 年至 2008 年,乳房 X 光检查率并未继续下降。即便如此,2008 年,接受过近期乳房 X 光检查的 40 岁以上女性比例仍低于 2010 年健康人目标的 70%,该目标在 2000 年已经达到。然而,2000 年、2005 年和 2008 年,50 至 64 岁的女性已经超过了健康人目标;目前,一些乳房 X 光检查率极低的群体正在迎头赶上。这些都是重要的公共卫生成就。