Division of Oncological Sciences, Knight Cancer Institute, Oregon Health & Science University, 3181 SW Sam Jackson Park Road, Portland, OR, 97239, USA.
Cancer Early Detection Advanced Research, Knight Cancer Institute, Oregon Health & Science University, 3181 SW Sam Jackson Park Road, Portland, OR, 97239, USA.
Cancer Causes Control. 2022 Feb;33(2):293-301. doi: 10.1007/s10552-021-01529-8. Epub 2022 Jan 7.
Women with breast cancer diagnosed from mammogram screenings have a lower mortality risk than women diagnosed from symptoms. Currently, the U.S Preventive Services Task Force recommends biannual screening for women aged 50-74 years old. In this study, we aimed to identify factors associated with inadequate screening defined as "no mammogram screening within past 2 years" to guide cancer prevention and early detection efforts.
This study utilized area-based probabilistic sampling survey data, collected across Oregon in 2019. Dataset weights were calculated using a raking approach. Demographic and behavior information were collected with existing validated questionnaire items from national surveys. Weighted multivariable logistic regression analyses with missing-value imputations were conducted to identify factors associated with inadequate mammogram screening.
The study included 254 women 50-74 years old without previous breast or ovarian cancer history. 19.29% of the sample reported no mammogram within two years, including 1.57% with no previous mammograms. Following unadjusted analyses, the significant factors included education, occupation status, health insurance and smoking and were therefore included into the adjusted model. In the multivariate adjusted model education remained significant while occupation status, health insurance and smoking were no longer significant. Compared to women with a college graduate degree, women with less than college graduate degree were at higher risk of inadequate screening [OR (95% CI) = 3.23 (1.54, 6.74)].
Lack of education was significantly associated with inadequate mammogram screening even after adjusting for occupation status, health insurance and smoking, which should prompt further outreach and education.
与通过症状诊断的女性相比,通过乳房 X 光筛查诊断出患有乳腺癌的女性死亡率更低。目前,美国预防服务工作组建议 50-74 岁的女性每两年进行一次筛查。在这项研究中,我们旨在确定与定义为“过去 2 年内未进行乳房 X 光筛查”的不充分筛查相关的因素,以指导癌症预防和早期检测工作。
本研究利用基于区域的概率抽样调查数据,于 2019 年在俄勒冈州收集。使用耙式方法计算数据集权重。使用来自全国调查的现有经过验证的问卷项目收集人口统计学和行为信息。对缺失值进行插补的加权多变量逻辑回归分析用于确定与不充分乳房 X 光筛查相关的因素。
本研究纳入了 254 名年龄在 50-74 岁、无既往乳腺癌或卵巢癌病史的女性。19.29%的样本报告在过去两年内没有进行乳房 X 光检查,其中 1.57%的人没有进行过乳房 X 光检查。在未经调整的分析中,显著因素包括教育、职业状况、健康保险和吸烟,因此被纳入调整后的模型。在多变量调整模型中,教育仍然具有显著性,而职业状况、健康保险和吸烟则不再具有显著性。与大学毕业的女性相比,未完成大学学业的女性进行不充分乳房 X 光筛查的风险更高[比值比(95%置信区间)=3.23(1.54,6.74)]。
即使在调整职业状况、健康保险和吸烟因素后,缺乏教育与不充分乳房 X 光筛查显著相关,这应该促使进一步开展宣传和教育工作。