Department of Health Education and Promotion, College of Health and Human Performance, East Carolina University, 2307 Carol G. Belk Building, Mail Stop 529, Greenville, NC, 27858, USA.
South Carolina Statewide Cancer Prevention and Control Program, Department of Health Promotion, Education, and Behavior, Arnold School of Public Health, University of South Carolina, 915 Greene Street, Columbia, SC, 29208, USA.
J Community Health. 2020 Feb;45(1):20-29. doi: 10.1007/s10900-019-00697-8.
Updated United States Preventive Services Task Force (USPSTF) and American Cancer Society mammography screening recommendations push for increased age of initiation and lengthened breast cancer screening intervals. These changes have implications for the reduction of breast cancer mortality in Black women. The purpose of this study was to examine breast cancer screening behavior in a cohort of Southern Black women after the release of the 2009 USPSTF recommendations. Surveys assessing cancer screening information were collected from members of Black churches between 2006 and 2013. The sample was restricted to women aged 40 to 74 years, who did not report a breast cancer diagnosis, or a recent diagnostic mammogram (n = 789). Percentages of women ever completing a mammogram (age 40-49) and annual mammography (age 50-74) in 2006-2009 and 2010-2013 were compared using chi-square statistics. Logistic regression models were fit to determine the predictors of adherence to pre-2010 screening guidelines. No significant changes in mammography rates were found for women in the 40-49 age group (X = 0.42, p = 0.52) nor for those in the 50-74 age group (X = 0.67, p = 0.41). Completing an annual clinical breast exam was a significant predictor of adherence to pre-2010 screening guidelines for both age groups (OR 19.86 and OR 33.27 respectively) and participation in education sessions (OR 4.26). Stability in mammography behavior may be a result of PCP's advice, or community activities grounded pre-2010 screening recommendations. More research is needed to understand how clinical interactions and community-based efforts shape Black women's screening knowledge and practices.
更新后的美国预防服务工作组 (USPSTF) 和美国癌症协会的乳房 X 光筛查建议推动了起始年龄的提高和乳腺癌筛查间隔的延长。这些变化对降低黑人群体乳腺癌死亡率有一定影响。本研究旨在调查 2009 年 USPSTF 建议发布后，南方黑人女性的乳腺癌筛查行为。2006 年至 2013 年间，通过黑人教堂成员收集了评估癌症筛查信息的调查。该样本仅限于年龄在 40 至 74 岁之间、未报告乳腺癌诊断或近期接受诊断性乳房 X 光检查的女性（n=789）。使用卡方检验比较了 2006-2009 年和 2010-2013 年接受过乳房 X 光检查（40-49 岁）和每年乳房 X 光检查（50-74 岁）的女性的百分比。使用逻辑回归模型确定了遵守 2010 年前筛查指南的预测因素。在 40-49 岁年龄组的女性（X=0.42，p=0.52）和 50-74 岁年龄组的女性（X=0.67，p=0.41）中，乳房 X 光检查率均未发生显著变化。每年进行临床乳房检查是两个年龄组遵守 2010 年前筛查指南的重要预测因素（OR 分别为 19.86 和 33.27），参加教育课程（OR 为 4.26）也是重要预测因素。乳房 X 光检查行为的稳定性可能是初级保健医生建议或基于 2010 年前筛查建议的社区活动的结果。需要进一步研究，以了解临床互动和基于社区的努力如何影响黑人女性的筛查知识和实践。
