de Oliveira Evangelina Xavier Gouveia, Pinheiro Rejane Sobrino, Melo Enirtes Caetano Praates, Carvalho Marilia Sá
Grupo de Redes e Informação em Saúde, Fiocruz, Rio de Janeiro, RJ, 21045-900, Brazil.
Cien Saude Colet. 2011 Sep;16(9):3649-64. doi: 10.1590/s1413-81232011001000002.
This study examined the effect of population characteristics and geographic location of residences and services on the odds of receiving a mammography in 2003 and 2008. Patterns of mammography use were analyzed using data from the Health Supplements of the National Household Sample Survey for women aged over 25, using prevalence ratios, and for women over 40 using multivariate logistic regression, correcting for complex sample design effects. In 2003, 54.6% of women of 50-69 years of age reported having had a mammography, in 2008, 71.5%. The odds are higher for those 50 to 69 years old, and increase with family income, education, being married, having consulted a doctor and having health insurance. Living in a metropolitan area trebles the chance of mammography. Compared to the Northern region, residents in all other regions have greater odds, greater distances decrease the odds. Coverage increased in the age range targeted by national policy, and inequalities due to income and education on access to mammography were reduced but regional convergence was not marked. Increased access seems to relate more to policies of income distribution and social inclusion, and to the availability of the examination in the Unified Health System, than to an increasing number of mammography units.
本研究调查了人口特征、居住及服务地点的地理位置对2003年和2008年接受乳腺X线摄影几率的影响。使用全国家庭抽样调查健康补充数据，对25岁以上女性采用患病率比分析乳腺X线摄影使用模式，对40岁以上女性采用多变量逻辑回归分析，并校正复杂样本设计效应。2003年，50 - 69岁女性中有54.6%报告进行过乳腺X线摄影，2008年这一比例为71.5%。50至69岁人群接受乳腺X线摄影的几率更高，且随着家庭收入、教育程度、已婚、咨询过医生以及拥有医疗保险而增加。居住在大都市地区会使接受乳腺X线摄影的几率增至三倍。与北部地区相比，其他所有地区的居民接受乳腺X线摄影的几率更高，距离越远几率越低。在国家政策目标年龄范围内覆盖率有所提高，因收入和教育导致的乳腺X线摄影获取方面的不平等有所减少，但区域趋同并不明显。获取机会增加似乎更多与收入分配和社会包容政策以及统一卫生系统中该检查的可及性有关，而非与乳腺X线摄影单位数量增加有关。
