Radiation Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, 9609 Medical Center Drive, Room 7E-528, MSC 9778, Bethesda, MD, USA.
Social Epidemiology Research Unit, Social Behavioral Research Branch, National Human Genome Research Institute, National Institutes of Health, Bethesda, MD, USA.
J Cancer Surviv. 2022 Jun;16(3):514-530. doi: 10.1007/s11764-021-01046-2. Epub 2021 May 13.
Increasing number of breast cancer survivors in the USA have led to greater focus on the long-term health outcomes and surveillance care among these women. However limited evidence exists of use of surveillance mammography among breast cancer survivors and how it varies across racial/ethnic groups.
We conducted a systematic review of the literature to explore disparities in use of surveillance mammogram among women breast cancer survivors by searching for relevant studies published between 2000 and 2020 from Medline (Ovid), PubMed (National Library of Medicine), and PsycINFO (Ovid) bibliographic databases. Two authors independently screened titles, abstracts, and full texts of all articles that reported surveillance mammography use across racial/ethnic groups. Data on study design, screening eligibility, sample size, operational definition, and/or measure of the use of a surveillance mammogram among breast cancer survivors and the association between race/ethnicity and use of a surveillance mammogram were summarized in the evidence tables.
We identified 1544 records from the three databases, and 30 studies examined the use of surveillance mammograms among breast cancer survivors across race/ethnic groups. Of these, 21 provided adjusted estimates of racial/ethnic disparities in use of surveillance mammograms, and 15 of these reported statistically significant disparities. In summary, most studies reported that non-white women (mainly Blacks and Hispanics) were less likely to receive a timely surveillance mammogram compared to White.
This study extends the evidence of racial/ethnic disparities beyond completion of initial treatment by finding similar disparities in receipt of surveillance mammograms among breast cancer survivors.
Our findings identify a need to improve efforts to increase post-treatment use of surveillance mammography among racial/ethnic minority women to reduce these gaps and improve overall clinical and quality of life outcomes.
美国乳腺癌幸存者人数不断增加，这使得人们更加关注这些女性的长期健康结果和监测护理。然而，关于乳腺癌幸存者使用监测乳房 X 光检查的证据有限，并且这种情况在不同种族/族裔群体中存在差异。
我们通过搜索 Medline（Ovid）、PubMed（美国国家医学图书馆）和 PsycINFO（Ovid）书目数据库中 2000 年至 2020 年期间发表的相关研究，对文献进行了系统回顾，以探讨乳腺癌幸存者中监测乳房 X 光检查使用情况的差异。两位作者独立筛选了报告不同种族/族裔群体中监测乳房 X 光检查使用情况的所有文章的标题、摘要和全文。总结了研究设计、筛查资格、样本量、操作定义和/或监测乳腺癌幸存者使用监测乳房 X 光检查的措施，以及种族/族裔与使用监测乳房 X 光检查之间的关联。
我们从三个数据库中确定了 1544 条记录，其中 30 项研究检查了不同种族/族裔群体中乳腺癌幸存者使用监测乳房 X 光检查的情况。其中，21 项研究提供了监测乳房 X 光检查使用情况的种族/族裔差异的调整估计值，其中 15 项研究报告了统计学上显著的差异。总之，大多数研究报告称，与白人相比，非白人女性（主要是黑人女性和西班牙裔女性）不太可能及时接受监测乳房 X 光检查。
这项研究通过发现乳腺癌幸存者中接受监测乳房 X 光检查的相似差异，将种族/族裔差异的证据扩展到初始治疗完成之外。
我们的研究结果表明，需要加强努力，增加少数族裔女性接受治疗后监测乳房 X 光检查的使用，以缩小这些差距，提高整体临床和生活质量结果。
