School of Medicine, Texas Tech University Health Sciences Center, Lubbock, TX 79430, USA.
Julia Jones Matthews Department of Public Health, Texas Tech University Health Sciences Centre, Lubbock, TX 79430, USA.
Medicina (Kaunas). 2022 Jul 28;58(8):1010. doi: 10.3390/medicina58081010.
: Early detection through appropriate screening is key to curing breast cancer. The Access to Breast Care for West Texas (ABC4WT) program offers no-cost mammography to underserved women in West Texas. The U.S. Preventative Task Force (USPSTF) guidelines are breast cancer screening guidelines which suggest screening for all women at the age of 50 years. The focus of this study was to identify sociodemographic barriers and determinants for breast cancer screenings, as well as screening outcomes, in low income, uninsured, or under-insured communities in West Texas. : The ABC4WT program's patient database was queried from 1 November, 2018, to 1 June, 2021, for sociodemographic variables, screening history, and results to identify high-risk groups for outreach. The American College of Radiology's risk assessment and quality assurance tool, BI-RADS (Breast Imaging-Reporting and Data System), a widely accepted lexicon and reporting schema for breast imaging, was used for risk differentiation. The cancer rate for ABC4WT's program was significantly higher than the national mean (5.1), at 23.04 per 1000 mammograms. Of the 1519 mammograms performed, women between 40 and 49 years old represented the highest percentages of BI-RADS 4 and 5 (42.0% and 28.0%, respectively; = 0.049). This age group also received 43.7% of biopsies performed and comprised 28.6% ( = 10) of cancers diagnosed ( = 35) ( = 0.031). Additionally, participants with a monthly household income of less than USD 800/month/person were more likely to result in a cancer diagnosis (70.6%) than higher incomes (29.4%) ( = 0.021). These determinants most starkly impacted women 40-49 years old who would not have been screened by U.S. Preventative Services Task Force (USPSTF) guidelines. This population with increased cancer risk should be encouraged to undergo screening for breast cancer via mammography.
早期发现是治愈乳腺癌的关键。得克萨斯州西部的“为西部得克萨斯提供乳房护理”(ABC4WT)项目为得克萨斯州西部服务不足的女性提供免费乳房 X 光检查。美国预防服务工作组(USPSTF)的指南是乳腺癌筛查指南,建议所有女性在 50 岁时进行筛查。本研究的重点是确定社会人口统计学障碍和决定因素,以及在得克萨斯州西部低收入、没有保险或保险不足的社区进行乳腺癌筛查的结果。ABC4WT 项目的患者数据库从 2018 年 11 月 1 日至 2021 年 6 月 1 日进行了查询,以获取社会人口统计学变量、筛查史和结果,以确定需要外联的高风险群体。美国放射学院的风险评估和质量保证工具 BI-RADS(乳房成像报告和数据系统),是一种广泛接受的乳房成像词汇和报告方案,用于风险区分。ABC4WT 项目的癌症发病率明显高于全国平均水平(5.1),为每 1000 次乳房 X 光检查 23.04 例。在进行的 1519 次乳房 X 光检查中,40 至 49 岁的女性 BI-RADS 4 和 5 的比例最高(分别为 42.0%和 28.0%; = 0.049)。该年龄组还接受了 43.7%的活检,占诊断出的癌症的 28.6%( = 10)( = 35)( = 0.031)。此外,每月家庭收入低于 800 美元/人/月的参与者更有可能被诊断出癌症(70.6%),而收入较高的参与者则为 29.4%( = 0.021)。这些决定因素对不符合美国预防服务工作组(USPSTF)指南的 40-49 岁女性影响最大。应鼓励这一具有较高癌症风险的人群通过乳房 X 光检查进行乳腺癌筛查。