Population Health Evaluation Center, College of Nursing, South Dakota State University.
Mathematics and Statistics Department, South Dakota State University.
S D Med. 2023 Feb;76(2):76-79.
Breast cancer is the most common cancer among women and early detection is critical to improve breast cancer survival. The All Women Count! (AWC!) Program, part of the National Breast and Cervical Cancer Early Detection Program, provides breast and cervical screening services at no cost to underserved women in South Dakota. Aiming to investigate program participation, we examined trends in the number of women eligible for breast cancer screening services through the AWC! Program along with mammography screening participation by county.
Using the State-level Small Area Health Insurances Estimates data and the AWC! data, we calculated the proportion of South Dakotan women eligible for mammography screening under the AWC! Program from 2016 to 2019, and calculated the standardized participation ratio and 95 percent confidence interval by county (2019). To investigate differences in screening participation over time and by counties, analysis of variance (ANOVA) and Tukey statistical test were conducted, respectively.
From 2016 to 2019, the number of women eligible for breast cancer screening services declined by 12 percent. Differences in screening participation were not statistically significant over the four-year period. Conversely, county-level variations in screening participation were found. In 2019, among the 59 counties with screening data, 15 percent presented statistically higher participation in screening.
A decrease in the number of women eligible for breast cancer services provided by AWC! was observed. Additionally, screening participation varied by county. A more comprehensive investigation is needed to explain these geographic disparities so prevention strategies can reduce the burden of breast cancer among South Dakota underserved women.
乳腺癌是女性中最常见的癌症，早期发现对于提高乳腺癌生存率至关重要。All Women Count!（AWC!）计划是国家乳腺癌和宫颈癌早期检测计划的一部分，为南达科他州服务不足的女性提供免费的乳腺癌和宫颈癌筛查服务。本研究旨在调查该计划的参与情况，我们研究了通过 AWC! 计划有资格获得乳腺癌筛查服务的女性数量的趋势，以及各县的乳房 X 光检查筛查参与情况。
我们使用州级小区域医疗保险估计数据和 AWC! 数据，计算了 2016 年至 2019 年期间 AWC! 计划下南达科他州女性接受乳房 X 光检查筛查的比例，并按县计算了标准化参与率和 95%置信区间（2019 年）。为了调查随时间和各县筛查参与情况的差异，我们分别进行了方差分析（ANOVA）和图基统计检验。
从 2016 年到 2019 年，有资格接受乳腺癌筛查服务的女性人数减少了 12%。在四年期间，筛查参与率没有统计学上的显著差异。相反，我们发现了各县筛查参与率的差异。2019 年，在有筛查数据的 59 个县中，有 15%的县的筛查参与率统计上更高。
我们观察到 AWC! 提供的乳腺癌服务有资格的女性人数减少。此外，筛查参与情况因县而异。需要更全面的调查来解释这些地理差异，以便预防策略能够降低南达科他州服务不足的女性患乳腺癌的负担。
