Division of Cancer Control and Population Sciences, National Institute, Bethesda, Maryland 20852-7344, USA.
Cancer. 2011 Dec 15;117(24):5450-60. doi: 10.1002/cncr.26218. Epub 2011 Aug 22.
In 2005, mammography rates in the United States dropped nationally for the first time among age-eligible women. An increased risk of breast cancer related to hormone therapy (HT) use reported in 2002 led to a dramatic drop in its use by 2005. Because current users of HT also tend to have higher mammography rates, the authors examined whether concurrent drops in HT and mammography use were associated.
Multivariate logistic regression was used to test for an interaction between HT use and survey year, controlling for a range of measurable factors in data from the 2000 and 2005 National Health Interview Surveys (NHIS).
Women ages 50 to 64 years were more likely to report a recent mammogram if they also reported more education, a usual source of care, private health insurance, any race except non-Hispanic Asian, talking with an obstetrician/gynecologist or other physician in the past 12 months, or were currently taking HT. Women aged ≥ 65 years were more likely to report a recent mammogram if they also reported younger age (ages 65-74 years), more education, a usual source of care, having Medicare Part B or other supplemental Medicare insurance, excellent health, any race except non-Hispanic Asian, talking with an obstetrician/gynecologist or other physician in the past 12 months, or were currently taking HT.
The change in HT use was associated with the drop in mammography use for women ages 50 to 64 years but not for women aged ≥ 65 years. NHIS data explained 70% to 80% of the change in mammography use.
2005 年,美国符合条件的女性中,乳腺 X 光检查率首次出现全国性下降。2002 年报告的激素治疗(HT)使用与乳腺癌风险增加相关,导致 2005 年 HT 的使用量急剧下降。由于当前使用 HT 的女性也往往有更高的乳腺 X 光检查率,作者研究了 HT 和乳腺 X 光检查使用量同时下降是否存在关联。
使用多变量逻辑回归检验 HT 使用与调查年份之间的交互作用,控制了 2000 年和 2005 年全国健康访谈调查(NHIS)数据中一系列可衡量因素。
50 至 64 岁的女性如果报告了更多的教育程度、常规医疗来源、私人医疗保险、除非西班牙裔亚裔以外的任何种族、过去 12 个月内与妇产科医生或其他医生交谈过,或者正在服用 HT,则更有可能报告最近进行过乳腺 X 光检查。65 岁及以上的女性如果报告了更年轻的年龄(65-74 岁)、更多的教育程度、常规医疗来源、拥有 Medicare Part B 或其他补充 Medicare 保险、健康状况良好、除非西班牙裔亚裔以外的任何种族、过去 12 个月内与妇产科医生或其他医生交谈过,或者正在服用 HT,则更有可能报告最近进行过乳腺 X 光检查。
HT 使用的变化与 50 至 64 岁女性的乳腺 X 光检查使用率下降有关,但与 65 岁及以上女性无关。NHIS 数据解释了乳腺 X 光检查使用率变化的 70%至 80%。