澳大利亚大悉尼地区乳腺癌筛查参与度与居住区域社会人口特征、地理可达性以及筛查场所位置特征之间的关联。

Associations between breast cancer screening participation and residential area sociodemographic features, geographic accessibility, and features of screening venue location in Greater Sydney, Australia.

机构信息

Australian Geospatial Health Laboratory, Health Research Institute, University of Canberra, Canberra, Australian Capital Territory, Australia; School of Health Sciences, University of South Australia, Adelaide, Australia.

Australian Geospatial Health Laboratory, Health Research Institute, University of Canberra, Canberra, Australian Capital Territory, Australia.

出版信息

Prev Med. 2021 Dec;153:106774. doi: 10.1016/j.ypmed.2021.106774. Epub 2021 Aug 24.

DOI:10.1016/j.ypmed.2021.106774

PMID:34450190

Abstract

Breast cancer screening (BCS) participation rates are often suboptimal and vary geographically. Environmental features may influence BCS participation, but few studies have assessed this relationship. This study assessed the associations between BCS participation, residential area sociodemographic characteristics, distance to BCS venue, and venue location attributes. Data for 384,433 women residing in Greater Sydney, Australia, invited to BCS during 2011-2014 were spatially joined to their state suburb (SSC) (n = 800). SSC sociodemographic measures included women's median age, proportion women speaking English at home, full-time employed, and university educated; and proportion dwellings with motor-vehicles. Road network distance was calculated to each BCS venue. BCS venues were coded as co-located with bus-stop, train-station, hospital, general practitioner (GP), and shop. Hot spots were calculated to quantify spatial clustering of BCS participation. Multilevel logistic models were used to estimate the associations between environmental predictors and BCS participation, accounting for SSC-level clustering. BCS participation was 53.9% and spatially clustered. BCS was positively associated with SSC-level median age for women, proportions women speaking English and university educated, and dwellings with motor-vehicles. Distance to venue was inversely associated with BCS. Venue co-location with GP was positively associated and co-location with bus-stop, train-station, and shop, hospital were negatively associated with BCS. Residential sociodemographic features, geographic access, and venue location attributes are associated with BCS participation. These findings implicate the relevance of social and built environmental factors to programmatic aims to raise BCS participation. Additional research on venue location features is required to understand where best to site BCS venues.

摘要

乳腺癌筛查（BCS）参与率往往不理想，且存在地域差异。环境特征可能会影响 BCS 的参与度，但很少有研究评估这种关系。本研究评估了 BCS 参与度、居住区域社会人口特征、到 BCS 场所的距离以及场所位置属性之间的关系。2011 年至 2014 年，澳大利亚大悉尼地区邀请了 384433 名女性参加 BCS，将这些女性的数据与她们所在的州郊区（SSC）（n=800）进行空间连接。SSC 的社会人口学指标包括女性的中位年龄、在家说英语的女性比例、全职工作和接受过大学教育的比例，以及有汽车的住宅比例。计算了到每个 BCS 场所的道路网络距离。对 BCS 场所进行了编码，以确定其是否与公共汽车站、火车站、医院、全科医生（GP）和商店位于同一地点。计算热点以量化 BCS 参与度的空间聚类。使用多水平逻辑模型，在考虑 SSC 水平聚类的情况下，估计环境预测因素与 BCS 参与度之间的关系。BCS 参与率为 53.9%，且呈现空间聚类。BCS 与 SSC 水平的女性中位年龄、说英语和接受过大学教育的女性比例以及有汽车的住宅比例呈正相关，与到场所的距离呈负相关。与 GP 位于同一地点的场所与 BCS 呈正相关，而与公共汽车站、火车站和商店以及医院位于同一地点的场所与 BCS 呈负相关。居住社会人口特征、地理可达性和场所位置属性与 BCS 参与度相关。这些发现表明，社会和建筑环境因素与提高 BCS 参与度的计划目标相关。需要进一步研究场所位置特征，以了解在哪里设置 BCS 场所最佳。