Institute of Public Health (ISPUP)-Epidemiology Research Unit (EPI Unit), Universidade do Porto, Porto, Portugal.
Institute of Public Health (ISPUP)-Epidemiology Research Unit (EPI Unit), Instituto de Saúde Pública da Universidade do Porto, Rua das Taipas, 135, 4050-600 Porto, Portugal. Email:
Prev Chronic Dis. 2017 Oct 19;14:E100. doi: 10.5888/pcd14.170054.
Understanding the patterns of mammography use and monitoring changes in use are essential to improving national health policy for breast cancer control. We aimed to describe the use of mammography in Portugal and to identify the determinants of its nonuse and underuse by examining data from the National Health Survey 2014.
We analyzed data on 8,758 women aged 30 years or older. We defined women at an eligible age for mammography as women aged 45 to 69. Women who reported a previous mammography test were classified as ever-users and grouped according to time since the most recent test. We computed the prevalence of mammography use, and we used Poisson regression models to obtain age-adjusted and education-adjusted prevalence ratios and 95% confidence intervals.
The overall prevalence of mammography use was 80.0%, whereas nonuse was 20.0% and underuse 27.3% among users. The prevalence of nonuse and underuse were lower and associations with sociodemographic characteristics, use of health care services, and behavioral factors were stronger among women aged 45 to 69 than among women aged 30 to 44 and women aged 70 or older. The prevalence of mammography use was generally higher in the northern areas of Portugal than in southern areas and varied by marital status, educational level, and household size. A more frequent use of health care services and healthier behaviors were associated with lower prevalences of both nonuse and underuse.
This study illustrates inequalities in mammography use and provides useful information for better allocation of resources in breast cancer screening.
了解乳房 X 光摄影的使用模式并监测其使用变化，对于改善国家乳腺癌控制卫生政策至关重要。我们旨在描述葡萄牙的乳房 X 光摄影使用情况，并通过检查 2014 年国家健康调查的数据，确定其未使用率和使用率不足的决定因素。
我们分析了 8758 名年龄在 30 岁或以上的女性的数据。我们将年龄在 45 至 69 岁之间的女性定义为有资格接受乳房 X 光摄影检查的女性。报告曾进行过乳房 X 光摄影检查的女性被归类为曾使用者，并根据最近一次检查的时间进行分组。我们计算了乳房 X 光摄影检查的使用率，并使用泊松回归模型得出了年龄调整和教育调整后的患病率比及其 95%置信区间。
乳房 X 光摄影检查的总使用率为 80.0%，而未使用率和使用率不足分别为 20.0%和 27.3%。在 45 至 69 岁的女性中，未使用率和使用率不足的比例较低，且与社会人口特征、卫生保健服务的使用以及行为因素的关联比 30 至 44 岁和 70 岁或以上的女性更强。葡萄牙北部地区的乳房 X 光摄影检查使用率普遍高于南部地区，且与婚姻状况、教育水平和家庭规模有关。更频繁地使用卫生保健服务和更健康的行为与未使用率和使用率不足的患病率降低有关。
本研究说明了乳房 X 光摄影检查使用率的不平等现象，并为更好地在乳腺癌筛查中分配资源提供了有用的信息。
