Department of Medicine, Johns Hopkins Bayview Medical Center, Johns Hopkins University School of Medicine, Baltimore, MD 21224, USA.
J Womens Health (Larchmt). 2013 Jul;22(7):637-42. doi: 10.1089/jwh.2012.4083. Epub 2013 Jun 14.
Efforts to increase mammographic screening for early detection of breast cancer among women of lower socioeconomic class and ethnic minorities have been largely unsuccessful. This study explores the receptivity of hospitalized women to inpatient mammography as a novel approach to enhance breast cancer screening.
A cross-sectional study was conducted among 210 hospitalized women, aged 50-75 years, admitted to the medicine services at Johns Hopkins Bayview Medical Center in early 2012. Unpaired t-test and Chi-square tests were used to compare characteristics, barriers, and receptivity to inpatient mammography among women adherent and non-adherent to screening guidelines.
One-third of women enrolled were African American, and 60% of study participants reported an annual household income of <$20,000. Thirty-nine percent were overdue for screening, of which, 13% never had a mammogram and 28% were at high risk for breast cancer (Gail score ≥1.7%). The commonly reported barriers to screening mammograms were failure to remember appointments and lack of transportation. Most women (91%) believed that it is important for healthcare providers to discuss breast cancer screening while patients are in the hospital. Sixty-eight percent of non-adherent women would agree to have an inpatient screening mammogram if it was due and offered.
A significant number of hospitalized women from lower socioeconomic class are at high risk of developing breast cancer and non-adherent to mammographic screening. Inpatient hospital stay may be a feasible time for screening and education to ensure adequate breast care and promote screening among these women.
为提高社会经济地位较低和少数族裔女性的乳腺癌早期筛查率，人们做出了诸多努力，但收效甚微。本研究旨在探讨在院女性对住院期间行乳腺 X 线检查（即入院筛查）的接受程度，以期为提高乳腺癌筛查率提供新方法。
2012 年初，我们对约翰霍普金斯湾景医疗中心内科住院的 210 名年龄在 50-75 岁之间的女性进行了横断面研究。采用独立样本 t 检验和卡方检验比较了符合和不符合筛查指南的女性的特征、障碍和对入院筛查的接受程度。
研究对象中 1/3 为非裔美国人，60%的参与者年收入低于 20000 美元。39%的参与者未及时进行筛查，其中 13%从未进行过乳腺 X 线检查，28%具有较高的乳腺癌发病风险（Gail 评分≥1.7%）。阻碍进行乳腺 X 线检查的常见原因为忘记预约和缺乏交通工具。大多数女性（91%）认为，医护人员在患者住院期间讨论乳腺癌筛查问题非常重要。如果有必要并提供入院筛查，68%的不依从者会同意进行乳腺 X 线检查。
许多社会经济地位较低的住院女性具有较高的乳腺癌发病风险，且不依从乳腺 X 线检查。住院期间可能是进行筛查和教育的可行时机，可确保这些女性获得充分的乳房保健并促进其进行筛查。
