Nguyen Kim H, Pasick Rena J, Stewart Susan L, Kerlikowske Karla, Karliner Leah S
Division of General Internal Medicine, Department of Medicine, University of California at San Francisco, San Francisco, California.
Division of Biostatistics, Department of Public Health Sciences, University of California at Davis, Davis, California.
Cancer. 2017 Sep 15;123(18):3468-3475. doi: 10.1002/cncr.30756. Epub 2017 Jun 12.
Delays in abnormal mammogram follow-up contribute to poor outcomes. In the current study, the authors examined differences in abnormal screening mammogram follow-up between non-Hispanic white (NHW) and Asian women.
The authors used a prospective cohort of NHW and Asian women with a Breast Imaging, Reporting and Data System (BI-RADS) abnormal result of category 0 or 3-plus in the San Francisco Mammography Registry between 2000 and 2010. Kaplan-Meier estimation for the median number of days to follow-up with a diagnostic radiologic test was performed, and the authors compared the percentage of women with follow-up at 30 days, 60 days, and 90 days and no follow-up at 1 year for Asian women overall (and Asian ethnic groups) and NHW women. In addition, the authors assessed the relationship between race/ethnicity and time to follow-up with adjusted Cox proportional hazards models.
Among Asian women, Vietnamese and Filipina women had the longest, and Japanese women the shortest, median follow-up (32 days, 28 days, and 19 days, respectively) compared with NHW women (15 days). The percentage of women receiving follow-up at 30 days was lower for Asians versus NHWs (57% vs 77%; P<.0001), and these disparities persisted at 60 days and 90 days for all Asian ethnic groups except Japanese. Asian women had a reduced hazard of follow-up compared with NHW women (adjusted hazard ratio, 0.70; 95% confidence interval, 0.69-0.72). Asian women also had a higher rate of receiving no follow-up compared with NHW women (15% vs 10%; P<.001); among Asian ethnic groups, Filipinas were found to have the highest percentage of women with no follow-up (18.1%).
Asian women, particularly Filipina and Vietnamese women, were less likely than NHW women to receive timely follow-up after an abnormal screening mammogram. Research should disaggregate Asian ethnicity to better understand and address barriers to effective cancer prevention. Cancer 2017;123:3468-75. © 2017 American Cancer Society.
乳腺钼靶检查异常后的随访延迟会导致不良后果。在本研究中，作者探讨了非西班牙裔白人（NHW）女性与亚洲女性在乳腺钼靶筛查异常随访方面的差异。
作者使用了旧金山乳腺钼靶登记处2000年至2010年间乳腺影像报告和数据系统（BI-RADS）分类为0类或3类及以上异常结果的NHW和亚洲女性前瞻性队列。对接受诊断性放射学检查的随访天数中位数进行了Kaplan-Meier估计，并比较了亚洲女性总体（及亚洲各民族）和NHW女性在30天、60天和90天进行随访以及1年未进行随访的女性百分比。此外，作者使用调整后的Cox比例风险模型评估了种族/民族与随访时间之间的关系。
与NHW女性（15天）相比，亚洲女性中，越南裔和菲律宾裔女性的随访天数中位数最长，日本裔女性最短（分别为32天、28天和19天）。亚洲女性在30天接受随访的比例低于NHW女性（57%对77%；P<.0001），除日本裔外，所有亚洲民族在60天和90天的这种差异依然存在。与NHW女性相比，亚洲女性的随访风险降低（调整后风险比为0.70；95%置信区间为0.69-0.72）。与NHW女性相比，亚洲女性未接受随访的比例也更高（15%对10%；P<.001）；在亚洲各民族中，菲律宾裔女性未接受随访的比例最高（18.1%）。
亚洲女性，尤其是菲律宾裔和越南裔女性，在乳腺钼靶筛查异常后接受及时随访的可能性低于NHW女性。研究应按亚洲不同民族进行分类，以更好地理解和解决有效癌症预防的障碍。《癌症》2017年；123:3468-75。©2017美国癌症协会。
