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项目 ScanVan:移动乳房 X 光检查服务,以减少纽约市医疗服务不足的女性中的社会经济障碍和种族差异。

Project ScanVan: Mobile mammography services to decrease socioeconomic barriers and racial disparities among medically underserved women in NYC.

机构信息

Eastchester High School, Student, 2 Stewart Pl, Eastchester, New York, 10709, USA.

Weill Cornell Medicine, Department of Radiology, 525 East 68th street, New York, NY, 10065, USA.

出版信息

Clin Imaging. 2021 Oct;78:60-63. doi: 10.1016/j.clinimag.2021.02.040. Epub 2021 Mar 19.

DOI:10.1016/j.clinimag.2021.02.040
PMID:33770557
Abstract

OBJECTIVE

To evaluate whether, with access to free screening services, uninsured minority women in NYC are able to successfully manage existing barriers to breast cancer screening.

METHODS

This is a retrospective cohort study, with permission to use de-identified data received from Project Renewal's ScanVan in 2019. Project Renewal ScanVan provides clinical breast exams, mammograms, and health education to low-income women. The screening mammograms were conducted in the ScanVan and read by a board-certified radiologist. The electronic medical records were reviewed with respect to the patients' BI-RADS category, insurance status, race, and age. Descriptive statistics were performed and cancer detection rate, recall rate, and positive predictive values (PPV1, PPV2, PPV3) were calculated.

RESULTS

In 2019, 66% (2499 of 3745) of patients who used the ScanVan were Hispanic & African American. 43% (1627 of 3745) of the women were uninsured, 15% (579 of 3745) of the women had Medicare, and 18% (676 of 3745) classified as other. 17 out of 3745 patients screened received a new diagnosis of breast cancer, corresponding to a cancer detection rate of 4.5/1000 screened. 258 were recalled, corresponding with a recall rate of 7%. The PPV1 was 6.5% (17/258); PPV2 was 29.8% (17/57); and PPV3 was 34% (17/50).

CONCLUSION

Barriers to breast cancer screening include lack of medical insurance, limited access to care, and the absence of a primary care physician. The mobile mammography screening van successfully overcame such barriers, providing uninsured women from racial minority groups with vital breast cancer screening and follow up care.

摘要

目的

评估在获得免费筛查服务的情况下,纽约市的未参保少数族裔女性是否能够成功克服乳腺癌筛查的现有障碍。

方法

这是一项回顾性队列研究,获得了 Project Renewal 的 ScanVan 在 2019 年提供的匿名数据许可。Project Renewal ScanVan 为低收入女性提供临床乳房检查、乳房 X 光检查和健康教育。筛查乳房 X 光检查在 ScanVan 中进行,并由经过董事会认证的放射科医生进行阅读。电子病历中审查了患者的 BI-RADS 类别、保险状况、种族和年龄。进行了描述性统计分析,并计算了癌症检出率、召回率和阳性预测值(PPV1、PPV2、PPV3)。

结果

2019 年,使用 ScanVan 的患者中有 66%(2499 名/3745 名)为西班牙裔和非裔美国人。43%(1627 名/3745 名)的女性没有保险,15%(579 名/3745 名)的女性有医疗保险,18%(676 名/3745 名)归类为其他。3745 名筛查患者中有 17 名被诊断出患有新的乳腺癌,对应的癌症检出率为 4.5/1000 筛查。有 258 人被召回,召回率为 7%。PPV1 为 6.5%(17/258);PPV2 为 29.8%(17/57);PPV3 为 34%(17/50)。

结论

乳腺癌筛查的障碍包括缺乏医疗保险、获得医疗服务的机会有限以及缺乏初级保健医生。移动乳房 X 光筛查车成功克服了这些障碍,为来自少数族裔的未参保女性提供了重要的乳腺癌筛查和后续护理。

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