西班牙裔及以移民为主的乳腺钼靶筛查人群中乳腺癌担忧情绪的预测因素
Predictors of Breast Cancer Worry in a Hispanic and Predominantly Immigrant Mammography Screening Population.
作者信息
April-Sanders Ayana, Oskar Sabine, Shelton Rachel C, Schmitt Karen M, Desperito Elise, Protacio Angeline, Tehranifar Parisa
机构信息
Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, New York.
Department of Sociomedical Sciences, Mailman School of Public Health, Columbia University, New York, New York.
出版信息
Womens Health Issues. 2017 Mar-Apr;27(2):237-244. doi: 10.1016/j.whi.2016.10.003. Epub 2016 Nov 15.
OBJECTIVE
Worry about developing breast cancer (BC) has been associated with participation in screening and genetic testing and with follow-up of abnormal screening results. Little is known about the scope and predictors of BC worry in Hispanic and immigrant populations.
METHODS
We collected in-person interview data from 250 self-identified Hispanic women recruited from an urban mammography facility (average age 50.4 years; 82% foreign-born). Women reported whether they worried about developing breast cancer rarely/never (low worry), sometimes (moderate worry), or often/all the time (high worry). We examined whether sociocultural and psychological factors (e.g., acculturation, education, perceived risk), and risk factors and objective risk for BC (e.g., family history, Gail model 5-year risk estimates, parity) predicted BC worry using multinomial and logistic regression.
RESULTS
In multivariable models, women who perceived higher absolute BC risk (odds ratio, 1.66 [95% confidence interval, 1.28-2.14] for a one-unit increase in perceived lifetime risk) and comparative BC risk (e.g., odds ratio, 2.73, 95% confidence interval, 1.23-6.06) were more likely to report high BC worry than moderate or low BC worry. There were no associations between BC worry and indicators of objective risk or acculturation.
CONCLUSIONS
In Hispanic women undergoing screening mammography, higher perceptions of BC risk, in both absolute and comparative terms, were associated independently with high BC worry, and were stronger predictors of BC worry than indicators of objective BC risk, including family history, mammographic density, and personal BC risk estimates.
目的
对患乳腺癌(BC)的担忧与参与筛查、基因检测以及对异常筛查结果的随访有关。对于西班牙裔和移民人群中乳腺癌担忧的范围和预测因素知之甚少。
方法
我们从一家城市乳房X光检查机构招募了250名自我认定为西班牙裔的女性,收集了她们的当面访谈数据(平均年龄50.4岁;82%为外国出生)。女性报告她们是很少/从不担心患乳腺癌(低担忧)、有时担心(中度担忧)还是经常/一直担心(高担忧)。我们使用多项和逻辑回归分析来研究社会文化和心理因素(如文化适应、教育程度、感知风险)以及乳腺癌的风险因素和客观风险(如家族史、盖尔模型5年风险估计、生育情况)是否能预测乳腺癌担忧。
结果
在多变量模型中,感知到更高绝对乳腺癌风险(感知终生风险每增加一个单位,优势比为1.66[95%置信区间,1.28 - 2.14])和相对乳腺癌风险(例如,优势比为2.73,95%置信区间,1.23 - 6.06)的女性,与中度或低度乳腺癌担忧相比,更有可能报告高乳腺癌担忧。乳腺癌担忧与客观风险指标或文化适应之间没有关联。
结论
在接受乳房X光筛查的西班牙裔女性中,对乳腺癌风险的更高感知,无论是绝对风险还是相对风险,都与高乳腺癌担忧独立相关,并且比客观乳腺癌风险指标(包括家族史、乳房X光密度和个人乳腺癌风险估计)更能有力地预测乳腺癌担忧。