Division of Cancer Prevention and Control, Centers for Disease Control and Prevention, Atlanta, Georgia 30341, USA.
J Womens Health (Larchmt). 2011 Oct;20(10):1479-84. doi: 10.1089/jwh.2010.2530. Epub 2011 Jul 20.
The National Breast and Cervical Cancer Early Detection Program (NBCCEDP) provides low-income, uninsured women with screening and diagnostic services for breast and cervical cancer. Our study was conducted to describe the demographic and practice characteristics of participating and nonparticipating physicians, as well as their beliefs, adoption of new screening technologies, and recommendations for breast and cervical cancer screening.
From a 2006-2007 nationally representative survey, we identified 1,111 practicing primary care physicians who provide breast and cervical cancer screenings and assessed their recommendations using clinical vignettes related to screening initiation, frequency, and cessation. Responses of physicians participating in the NBCCEDP were compared with those from nonparticipating physicians.
Of the physicians surveyed, 15% reported participation in the NBCCEDP, 65% were not participants, and 20% were not sure or did not respond to this question. Program physicians were significantly more likely to practice in multispecialty settings, in a rural location, and in a hospital or clinic setting and had more patients who were female and insured by Medicaid or uninsured compared with nonprogram physicians. Beliefs about the effectiveness of screening tools or procedures in reducing breast or cervical cancer mortality were similar by program participation. Adoption of new technologies, including digital mammography and human papillomavirus (HPV) testing, and making guideline-consistent recommendations for screening initiation, frequency, and cessation did not differ significantly by program participation.
Although there may be differences in physician characteristics and practice settings, the beliefs and screening practices for both breast and cervical cancer are similar between program and nonprogram providers.
国家乳腺癌和宫颈癌早期检测计划（NBCCEDP）为低收入、未投保的女性提供乳腺癌和宫颈癌的筛查和诊断服务。我们的研究旨在描述参与和未参与的医生的人口统计学和实践特征，以及他们对新筛查技术的采用和对乳腺癌和宫颈癌筛查的建议。
我们从 2006-2007 年的一项全国代表性调查中，确定了 1111 名提供乳腺癌和宫颈癌筛查的执业初级保健医生，并使用与筛查启动、频率和终止相关的临床案例评估了他们的建议。比较了参与 NBCCEDP 的医生的反应与未参与的医生的反应。
在接受调查的医生中，15%报告参与了 NBCCEDP，65%的医生没有参与，20%的医生对这个问题没有回答或不确定。与非项目医生相比，项目医生更有可能在多专科环境中、在农村地区、在医院或诊所环境中执业，并且有更多的女性患者和由医疗补助计划或未投保的患者。对筛查工具或程序在降低乳腺癌或宫颈癌死亡率方面的有效性的看法，因项目参与情况而异。对新技术的采用，包括数字乳房 X 线摄影术和人乳头瘤病毒（HPV）检测，以及对筛查启动、频率和终止提出符合指南的建议，在项目参与方面没有显著差异。
尽管医生的特征和实践环境可能存在差异，但项目和非项目提供者在乳腺癌和宫颈癌的筛查信念和实践方面相似。
