Howard University College of Medicine, Washington, DC; Department of Radiology, Massachusetts General Hospital, Boston, Massachusetts.
Department of Radiology, University of Wisconsin-Madison, Madison, Wisconsin; and Member, ACR PFCC Outreach Committee.
J Am Coll Radiol. 2024 Sep;21(9):1371-1379. doi: 10.1016/j.jacr.2024.05.005. Epub 2024 Jun 3.
There are limited data about food insecurity within the cancer screening setting. To inform the potential need for food insecurity interventions, our study evaluated the association between food security and mammographic screening among eligible participants.
Female respondents aged 40 to 74 years in the 2019 National Health Interview Survey without history of breast cancer were included. Food insecurity was assessed using the Six-Item Food Security Scale developed by the National Center for Health Statistics. The proportion of patients who reported mammographic screening within the last year was estimated, stratified by food security. Multiple variable logistic regression analyses evaluated the association between food security and mammography screening, adjusted for potential confounders. All analyses were performed accounting for complex survey design features.
In all, 8,956 weighted survey respondents met inclusion criteria; 90.1% were classified as having high or marginal food security, of whom 56.6% reported screening; 6.1% were classified with low food security, of whom 42.1% reported screening; and 3.8% were classified with very low food security, of whom 43.1% reported screening. In our unadjusted analyses, participants with low food security (P < .001) and very low food security (P < .001) were less likely to report screening within the last year. In our adjusted analyses, participants with food insecurity (P = .009) were less likely to report screening.
In a nationally representative cross-sectional survey, participants with food insecurity were less likely to report mammography screening. Radiology practices should consider screening patients for food insecurity and social determinants of health. Evidence-based food insecurity interventions may increase adherence to mammography screening.
癌症筛查环境中有关粮食不安全的资料有限。为了了解粮食不安全干预的潜在需求，我们的研究评估了在合格参与者中粮食安全与乳房 X 光筛查之间的关联。
纳入了 2019 年国家健康访谈调查中年龄在 40 岁至 74 岁之间、无乳腺癌病史的女性受访者。使用国家卫生统计中心开发的六项目粮食安全量表评估粮食不安全情况。根据粮食安全状况对报告去年内接受乳房 X 光筛查的患者比例进行分层。多变量逻辑回归分析评估了粮食安全与乳房 X 光筛查之间的关联，同时调整了潜在混杂因素。所有分析均考虑了复杂的调查设计特征。
总共纳入了 8956 名符合条件的加权调查受访者；90.1%被归类为高或边缘粮食安全，其中 56.6%报告了筛查；6.1%被归类为粮食不安全，其中 42.1%报告了筛查；3.8%被归类为非常低粮食安全，其中 43.1%报告了筛查。在未调整的分析中，低粮食安全（P<.001）和非常低粮食安全（P<.001）的参与者更不可能报告在过去一年中进行筛查。在调整后的分析中，粮食不安全的参与者（P=.009）更不可能报告筛查。
在一项具有全国代表性的横断面调查中，粮食不安全的参与者更不可能报告乳房 X 光筛查。放射科医生应考虑筛查患者的粮食不安全和健康的社会决定因素。基于证据的粮食不安全干预措施可能会提高对乳房 X 光筛查的依从性。
