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乳腺癌筛查:基于美国预防服务工作组和美国癌症协会指南更新的女性态度和信念。

Breast Cancer Screening: Women's Attitudes and Beliefs in Light of Updated United States Preventive Services Task Force and American Cancer Society Guidelines.

机构信息

1 Department of Internal Medicine, Mayo Clinic Arizona , Scottsdale, Arizona.

2 Department of Family Medicine, Mayo Clinic Rochester , Rochester, Minnesota.

出版信息

J Womens Health (Larchmt). 2019 Mar;28(3):302-313. doi: 10.1089/jwh.2017.6885. Epub 2018 Sep 11.

Abstract

BACKGROUND

In recently updated breast cancer screening guidelines, the American Cancer Society (ACS) and United States Preventive Services Task Force (USPSTF) recommended increasing mammography screening intervals for various age groups. In addition, ACS does not recommend clinical breast examination (CBE) for routine screening among average-risk women. Our study explores women's attitudes regarding screening mammography and CBE and evaluates the impact of the updated USPSTF and ACS guidelines on these attitudes.

MATERIALS AND METHODS

Six hundred fourteen patients presenting to Mayo Clinic, Arizona and Minnesota, in July 2016 completed a self-administered survey, which included a summary of the updated guidelines.

RESULTS

A majority of the 555 women who fit the inclusion criteria reported that CBE and mammogram are useful in detecting breast cancer and should be performed annually, and 51% of participants were unaware of the updated guidelines. Before reviewing the guidelines, 77% believed yearly CBE and 76% believed yearly mammogram was needed for routine screening. After reviewing the guidelines, the percentage of women who planned to continue with yearly CBE and mammogram decreased significantly to 61% and 64%, respectively (p < 0.001 and p < 0.001). Nearly half the participants (48%) believed the most influential reason for the guideline change was to decrease healthcare spending.

CONCLUSION

Breast cancer screening is well received among patients, and a majority of surveyed women were unaware of recent guideline changes. After reviewing the guidelines, there was a significant downward shift in intended screening frequency, although the majority still planned to undergo annual screening. Informing women about updated evidence-based guidelines may influence their knowledge, preferences, and opinions.

摘要

背景

在美国癌症协会(ACS)和美国预防服务工作组(USPSTF)最近更新的乳腺癌筛查指南中,建议为不同年龄段的人群增加乳房 X 光筛查的间隔时间。此外,ACS 不建议对一般风险女性进行常规筛查的临床乳房检查(CBE)。我们的研究探讨了女性对筛查性乳房 X 光检查和 CBE 的态度,并评估了更新的 USPSTF 和 ACS 指南对这些态度的影响。

材料和方法

2016 年 7 月,614 名在亚利桑那州和明尼苏达州梅奥诊所就诊的患者完成了一份自我管理的调查问卷,其中包括更新指南的摘要。

结果

符合纳入标准的 555 名女性中,大多数人报告 CBE 和乳房 X 光检查在检测乳腺癌方面有用,应每年进行一次,其中 51%的参与者不知道更新后的指南。在查看指南之前,77%的人认为每年进行 CBE,76%的人认为每年进行乳房 X 光检查是常规筛查所必需的。在查看指南后,计划继续每年进行 CBE 和乳房 X 光检查的女性比例分别显著下降到 61%和 64%(p<0.001 和 p<0.001)。近一半的参与者(48%)认为指南改变的最主要原因是为了降低医疗保健支出。

结论

乳腺癌筛查在患者中得到了很好的接受,大多数接受调查的女性都不知道最近的指南变化。在查看指南后,尽管大多数女性仍计划每年进行筛查,但计划的筛查频率明显下降。告知女性有关最新的基于证据的指南可能会影响她们的知识、偏好和意见。

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