Wang Gary X, Pizzi Beverly T, Miles Randy C, Dontchos Brian N, LaPointe Annette P, Lehman Constance D, Narayan Anand K
Department of Radiology, Massachusetts General Hospital, Boston, Massachusetts.
Technical Manager, Department of Radiology, Massachusetts General Hospital, Boston Massachusetts.
J Am Coll Radiol. 2020 Dec;17(12):1602-1608. doi: 10.1016/j.jacr.2020.07.007. Epub 2020 Jul 30.
The aim of this study was to evaluate the implementation and utilization of the Pink Card program, which links a physician-delivered reminder that a woman is due for screening mammography (SM) during an office visit with the opportunity to undergo walk-in screening.
In 2016, the authors' community-based breast imaging center provided physicians from three primary care and obstetrics and gynecology practices located in the same outpatient facility business card-sized Pink Cards to offer women due for SM during office visits. The card includes a reminder that screening is due and can be used to obtain SM on a walk-in basis. The primary outcome measure was the proportion of women who used Pink Cards among all screened women over 2 years. Independent predictors of Pink Card utilization were evaluated using multivariate logistic regression analyses.
Among 3,688 women who underwent SM, Pink Cards were used by 19.9% (733 of 3,688). Compared with women with prescheduled screening visits, Pink Card users were more likely to be Asian (odds ratio [OR], 1.37; P =.032), Black (OR, 2.05; P = .002), and Medicaid insured (OR, 1.71; P = .013) and less likely to use English as their primary language (OR, 2.75; P = .003). Additionally, Pink Card users were less likely to be up to date for biennial SM compared with women with prescheduled visits (31.9% [234 of 733] versus 66.6% [1,968 of 2,955], P < .001).
The Pink Card walk-in SM program can improve screening access, particularly for racial/ethnic minorities and Medicaid-insured patients. Expansion of this program may help reduce disparities and increase engagement in breast cancer screening.
本研究旨在评估粉红卡项目的实施情况和使用情况,该项目将医生在门诊就诊时提供的女性应接受乳腺钼靶筛查(SM)的提醒与即时筛查的机会联系起来。
2016年,作者所在的社区乳腺影像中心为位于同一门诊机构的三家初级保健以及妇产科诊所的医生提供了名片大小的粉红卡,以便在门诊就诊时向应接受SM的女性提供。该卡片包含筛查到期的提醒,可用于即时进行SM。主要结局指标是在两年内所有接受筛查的女性中使用粉红卡的女性比例。使用多因素逻辑回归分析评估粉红卡使用的独立预测因素。
在3688名接受SM的女性中,19.9%(3688名中的733名)使用了粉红卡。与预先安排筛查就诊的女性相比,粉红卡使用者更可能是亚洲人(比值比[OR],1.37;P = 0.032)、黑人(OR,2.05;P = 0.002)以及参加医疗补助保险的人(OR,1.71;P = 0.013),且不太可能以英语作为主要语言(OR,2.75;P = 0.003)。此外,与预先安排就诊的女性相比,粉红卡使用者进行两年一次SM的最新率较低(31.9%[733名中的234名]对66.6%[2955名中的1968名],P < 0.001)。
粉红卡即时SM项目可改善筛查可及性,尤其是对少数种族/族裔和参加医疗补助保险的患者。扩大该项目可能有助于减少差异并提高乳腺癌筛查的参与度。