Department of Epidemiology, Columbia University Mailman School of Public Health, New York, New York.
Department of Sociomedical Sciences, Columbia University Mailman School of Public Health, New York, New York.
Cancer Epidemiol Biomarkers Prev. 2021 Oct;30(10):1913-1920. doi: 10.1158/1055-9965.EPI-21-0172. Epub 2021 Aug 4.
New York State law mandates that women with dense breasts receive a written notification of their breast density (BD) and its implications, but data on the impact of dense breast notification (DBN) on BD awareness and knowledge in diverse populations remain limited.
Between 2016 and 2018, we collected survey and mammographic data from 666 women undergoing screening mammography in New York City (ages 40-60, 80% Hispanic, 69% Spanish-speaking) to examine the impact of prior DBN on BD awareness by sociodemographic and breast cancer risk factors, and describe BD knowledge by sources of information.
Only 24.8% of the overall sample and 34.9% of women receiving DBN had BD awareness. In multivariable models adjusting for DBN, awareness was significantly lower in women who were Spanish-speaking [OR, 0.16; 95% confidence interval (CI), 0.09-0.30 vs. English speakers], were foreign-born (OR, 0.31; 95% CI, 0.16-0.58 vs. U.S.-born), and had lower educational attainment (e.g., high school degree or less; OR, 0.14; 95% CI, 0.08-0.26 vs. college or higher degree). Women receiving DBN were more likely to be aware of BD (OR, 2.61; 95% CI, 1.59-4.27) but not more knowledgeable about the impact of BD on breast cancer risk and detection. However, women reporting additional communication about their BD showed greater knowledge in these areas.
DBN increases BD awareness disproportionately across sociodemographic groups.
Efforts to improve communication of DBN must focus on addressing barriers in lower socioeconomic and racially and ethnically diverse women, including educational and language barriers.
纽约州法律规定，乳房致密的女性应收到关于其乳房密度（BD）及其影响的书面通知，但关于致密乳房通知（DBN）对不同人群中 BD 意识和知识的影响的数据仍然有限。
在 2016 年至 2018 年期间，我们从纽约市进行筛查乳房 X 光检查的 666 名女性中收集了调查和乳房 X 光数据，以检查先前的 DBN 对社会人口统计学和乳腺癌风险因素的 BD 意识的影响，并按信息来源描述 BD 知识。
只有 24.8%的总体样本和 34.9%的接受 DBN 的女性有 BD 意识。在调整 DBN 的多变量模型中，讲西班牙语的女性[比值比，0.16；95%置信区间（CI），0.09-0.30 与讲英语的女性相比]、外国出生的女性[比值比，0.31；95%CI，0.16-0.58 与美国出生的女性相比]和受教育程度较低的女性（例如，高中或以下学历；比值比，0.14；95%CI，0.08-0.26 与大学或更高学历的女性相比）的意识明显较低。接受 DBN 的女性更有可能意识到 BD（比值比，2.61；95%CI，1.59-4.27），但对 BD 对乳腺癌风险和检测的影响的了解程度并不高。但是，报告关于其 BD 进行额外沟通的女性在这些方面表现出更高的知识。
DBN 不成比例地增加了不同社会人口统计学群体的 BD 意识。
改善 DBN 沟通的努力必须集中解决社会经济地位较低以及种族和族裔多样化的女性面临的障碍，包括教育和语言障碍。
