Department of Epidemiology and Biostatistics, Mel and Enid Zuckerman College of Public Health, University of Arizona, 1295 N Martin Ave., Tucson, AZ 85724, USA.
Department of Family and Community Medicine, College of Medicine, University of Arizona, 1601 N Tucson Blvd., Ste 32, Tucson, AZ 85716, USA.
Int J Environ Res Public Health. 2023 Dec 22;21(1):19. doi: 10.3390/ijerph21010019.
Hispanic and American Indian (AI) women experience lower breast cancer incidence than non-Hispanic White (NHW) women, but later-stage diagnoses and lower survival rates, suggesting issues with screening and healthcare access. Between 1999-2015, NHW breast cancer incidence decreased by 10% but increased by 8% for AI women. This study used 2016 and 2018 Behavioral Risk Factor Surveillance System data for Arizona and New Mexico to explore mammography screening. Analyses included Hispanic, AI, and NHW women aged ≥40 years ( = 12,830) to calculate age-specific compliance by race/ethnicity, logistic regression, and adjusted and sample-weighted evaluated associations between compliance and socio-economic covariates. In total, 75.1% of Hispanic women aged 50-74 reported mammography in the past two years (United States Preventive Services Task Force compliant) compared to 73.9% of NHW and 71.0% of AI women. Women who reported doctor visits in the past 12 months were likelier to comply than those without (AOR = 4.2 for Hispanic, 2.9 for AI, and 3.2 for NHW women). Reporting access to a personal doctor was related to compliance, except for AI women. While screening compliance was over 74%, visiting a healthcare provider in the past 12 months was essential. AI women reported issues that suggest unique challenges when deciding on mammography.
西班牙裔和美洲印第安裔（AI）女性的乳腺癌发病率低于非西班牙裔白人（NHW）女性，但诊断较晚，生存率较低，这表明在筛查和获得医疗保健方面存在问题。1999 年至 2015 年间，NHW 乳腺癌发病率下降了 10%，而 AI 女性的发病率则上升了 8%。本研究使用了 2016 年和 2018 年亚利桑那州和新墨西哥州的行为风险因素监测系统数据，探讨了乳房 X 光检查的情况。分析包括年龄≥40 岁的西班牙裔、AI 和 NHW 女性（n=12830），按种族/族裔计算特定年龄的合规率，使用逻辑回归和调整后的样本加权评估合规性与社会经济协变量之间的关联。在 50-74 岁的西班牙裔女性中，有 75.1%的人在过去两年内接受过乳房 X 光检查（符合美国预防服务工作组的标准），而 NHW 女性和 AI 女性的这一比例分别为 73.9%和 71.0%。在过去 12 个月内有就诊记录的女性比没有就诊记录的女性更有可能遵守规定（西班牙裔女性的比值比为 4.2，AI 女性的比值比为 2.9，NHW 女性的比值比为 3.2）。报告能获得私人医生的女性更有可能遵守规定，而 AI 女性则并非如此。虽然筛查的合规率超过了 74%，但在过去 12 个月内就诊仍然是至关重要的。AI 女性报告了一些问题，这表明在决定接受乳房 X 光检查时存在独特的挑战。
