Department of Clinical Epidemiology, Predictive Medicine and Public Health, University of Porto Medical School, Porto, Portugal.
Eur J Public Health. 2013 Jun;23(3):386-92. doi: 10.1093/eurpub/cks103. Epub 2012 Aug 8.
Understanding the patterns of mammography use is essential to promote the participation in breast cancer screening.
To describe the patterns of screening mammography use in Portugal.
As part of the fourth National Health Survey (2005/2006), 3045 women were evaluated in face-to-face interviews. The previous use of mammography for screening was classified as never or ever, and the latter was further grouped according to the time elapsed since the latest mammography. Having undergone the latest mammography >2 years before was considered underuse. We assessed the determinants of never having been screened by mammography and, among those who had been tested, the determinants of mammography underuse, through age- and education-adjusted odds ratios (ORs), with 95% confidence intervals (95% CIs).
Among women aged 45-49 and 50-69 years, 86.3% and 88.0%, respectively, underwent a screening mammography before, and most of them were tested in the previous 2 years. The lowest risk of never having been screened was in Norte (OR = 0.41, 95% CI: 0.21-0.80) and the highest in Açores (OR = 4.04, 95% CI: 2.37-6.92), in comparison with Centro (the region with organized screening for a longer time). Participants with <4 years of formal education were more likely to have never been screened than the more educated (OR = 4.27, 95% CI: 1.67-10.89). Women with private health insurance (OR = 0.16, 95% CI: 0.04-0.65), as well as those who had undergone cervical cytology screening before (OR = 0.50, 95% CI: 0.30-0.85), had a lower risk of underuse.
This study provides useful information to improve the allocation of resources to breast cancer screening.
了解乳房 X 光检查的使用模式对于促进乳腺癌筛查的参与至关重要。
描述葡萄牙的筛查性乳房 X 光检查使用模式。
作为第四次国家健康调查(2005/2006 年)的一部分,对 3045 名妇女进行了面对面访谈。将之前用于筛查的乳房 X 光检查分类为从未或曾经进行过,并根据最近一次乳房 X 光检查以来的时间进一步分组。最新乳房 X 光检查 >2 年前被认为是使用不足。我们评估了从未接受过乳房 X 光检查筛查的决定因素,以及在接受过检查的妇女中,使用不足的决定因素,通过年龄和教育调整的优势比(OR),置信区间(95%CI)为 95%。
在 45-49 岁和 50-69 岁的妇女中,分别有 86.3%和 88.0%接受了筛查性乳房 X 光检查,其中大多数在过去 2 年内接受了检查。从未接受过筛查的风险最低的是 Norte(OR = 0.41,95%CI:0.21-0.80),风险最高的是 Açores(OR = 4.04,95%CI:2.37-6.92),与 Centro(组织筛查时间较长的地区)相比。与受过更多教育的人相比,受教育程度较低的人更有可能从未接受过筛查(OR = 4.27,95%CI:1.67-10.89)。有私人健康保险的妇女(OR = 0.16,95%CI:0.04-0.65)以及之前接受过宫颈细胞学筛查的妇女(OR = 0.50,95%CI:0.30-0.85),使用不足的风险较低。
本研究提供了有用的信息,以改善乳腺癌筛查资源的分配。