健康不平等：有色人种女性的吸烟状况与乳房 X 光筛查之间的关联。
A Health Inequity: Associations Between Cigarette Smoking Status and Mammogram Screening Among Women of Color.
机构信息
Department of Psychological, Health and Learning Sciences, University of Houston, TX, USA.
出版信息
Nicotine Tob Res. 2023 Jan 1;25(1):66-72. doi: 10.1093/ntr/ntac175.
INTRODUCTION
We evaluated differences in yearly mammogram screening by smoking status in a sample of US women. We also examined differences in mammogram screening by race/ethnicity, age, and health care coverage.
METHODS
Data were from 1884 women participants in the 2018 Health of Houston Survey study. Binary logistic regression was used to assess the association between smoking status (current/former/non-smokers) and mammograms within 12 months. Moderators included race/ethnicity (Hispanic, Black, Asian, Other, White), age, and health care coverage.
RESULTS
In comparison to women who were non-smokers, current and former smokers showed lower odds to get a yearly mammogram (OR = 0.720; 95% CI = 0.709, .730 and OR = 0.702; 95% CI = 0.693, 0.710, respectively). Current smokers who identified as Hispanic or Black women and former smokers who identified as Hispanic, Asian, and other women showed lower odds of getting a mammogram (OR = 0.635, 95% CI = 0.611, 0.659; OR = 0.951, 95% CI = 0.919, 0.985) and (OR = 0.663, 95% CI = 0.642, 0.684; OR = 0.282, 95% CI = 0.263, 0.302; OR = 0.548, 95% CI = 0.496, 0.606) compared to White women. There were significant interactions by age and health care coverage.
CONCLUSIONS
Women of color who are current and former smokers showed lower odds to engage in mammogram screening, thus increasing their risk of undiagnosed breast cancer when compared to non-smokers. Ethnically diverse women already experience increased health disparities and smoking puts them at exacerbated risk of health complications and death.
IMPLICATIONS
Our findings suggest that smoking status is a modifiable behavioral risk factor that requires further attention in the prevention of breast cancer in ethnic minority women. Health care institutions and policymakers need to increase their awareness of and outreach efforts to women of color who smoke. These outreach efforts should focus on increasing access to smoking interventions and cancer screenings.
简介
我们评估了美国女性样本中按吸烟状况划分的年度乳房 X 光筛查差异。我们还检查了按种族/族裔、年龄和医疗保险覆盖范围划分的乳房 X 光筛查差异。
方法
数据来自 2018 年休斯顿健康调查研究的 1884 名女性参与者。二元逻辑回归用于评估吸烟状况（当前/以前/非吸烟者）与 12 个月内乳房 X 光检查之间的关联。调节剂包括种族/族裔（西班牙裔、黑人、亚洲人、其他、白人）、年龄和医疗保险覆盖范围。
结果
与不吸烟者相比，当前吸烟者和以前吸烟者进行年度乳房 X 光检查的可能性较低（OR=0.720；95%CI=0.709，0.730 和 OR=0.702；95%CI=0.693，0.710）。被确定为西班牙裔或黑人的当前吸烟者和被确定为西班牙裔、亚洲人和其他女性的以前吸烟者进行乳房 X 光检查的可能性较低（OR=0.635，95%CI=0.611，0.659；OR=0.951，95%CI=0.919，0.985)和（OR=0.663，95%CI=0.642，0.684；OR=0.282，95%CI=0.263，0.302；OR=0.548，95%CI=0.496，0.606）与白人女性相比。年龄和医疗保险覆盖范围存在显著的相互作用。
结论
目前和以前吸烟的有色人种女性进行乳房 X 光筛查的可能性较低，因此与不吸烟者相比，她们罹患未确诊乳腺癌的风险增加。不同种族的女性已经经历了更多的健康差距，而吸烟使她们面临更严重的健康并发症和死亡风险。
意义
我们的研究结果表明，吸烟状况是一个可改变的行为风险因素，需要在少数民族妇女的乳腺癌预防中进一步关注。医疗机构和政策制定者需要提高对吸烟的认识，并加大对有色人种女性的宣传力度。这些宣传工作应侧重于增加获得吸烟干预和癌症筛查的机会。
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