Bensken Wyatt P, Larson Zoe, Kaufmann Jorge, Mertes Gretchen, Lyon-Scott Kristin, Lucas Jennifer A, Marino Miguel, Heintzman John D
Department of Research, OCHIN, Portland, OR, USA.
Department of Family Medicine, Oregon Health & Science University, Portland, OR, USA.
J Racial Ethn Health Disparities. 2025 Apr 11. doi: 10.1007/s40615-025-02413-w.
In the United States, Latina women have delayed mammography utilization, yet it is unknown how use varies among patients who receive primary care from community health centers who serve a disproportionately high number of Latina patients.
We used data (2013-2022) from a nationwide network of primary care organizations. The main outcome of interest, mammography among females over the age of 50, was analyzed in two different ways: (1) being up to date on mammography and (2) time to first mammogram after age 50. We used covariate-adjusted generalized estimating equations logistic regression and Cox proportional hazard models to estimate the association between nativity (US-born versus Foreign-born, region of origin, and country of origin) and mammography.
Among the 24,579 included patients, being up to date with mammography varied by nativity, with US-born Latinas having 1.55 (95% CI: 1.27, 1.90) and Foreign-born Latinas having 1.85 (95% CI: 1.64, 2.10) times the odds of being up to date compared to Non-Hispanic White (NHW) females. Foreign-born Latinas, regardless of region or country of origin, had a higher prevalence of being up to date compared to US-born NHW and US-born Latinas. Latinas from the Caribbean and Central America had the highest prevalence of being up to date, with those from South America having the lowest. Finally, US-born Latinas and Foreign-born Latinas had a shorter time to first mammography.
US-born and Foreign-born Latinas had greater mammography use than NHW patients highlighting the important role of community health centers in preventive cancer care for Latinas.
在美国,拉丁裔女性的乳房X光检查利用率较低,但对于在社区卫生中心接受初级保健的患者(这些中心服务的拉丁裔患者数量不成比例地高),其使用率如何变化尚不清楚。
我们使用了来自全国初级保健组织网络的数据(2013 - 2022年)。感兴趣的主要结果,即50岁以上女性的乳房X光检查,通过两种不同方式进行分析:(1)乳房X光检查最新情况;(2)50岁后首次进行乳房X光检查的时间。我们使用协变量调整的广义估计方程逻辑回归和Cox比例风险模型来估计出生地(美国出生与外国出生、原籍地区和原籍国)与乳房X光检查之间的关联。
在纳入的24,579名患者中,乳房X光检查最新情况因出生地而异,与非西班牙裔白人(NHW)女性相比,美国出生的拉丁裔女性进行乳房X光检查最新的几率是其1.55倍(95%置信区间:1.27, 1.90),外国出生的拉丁裔女性是其1.85倍(95%置信区间:1.64, 2.10)。无论原籍地区或国家如何,外国出生的拉丁裔女性进行乳房X光检查最新的患病率高于美国出生的NHW和美国出生的拉丁裔女性。来自加勒比地区和中美洲的拉丁裔女性进行乳房X光检查最新的患病率最高,南美洲的最低。最后,美国出生的拉丁裔女性和外国出生的拉丁裔女性首次进行乳房X光检查的时间较短。
美国出生和外国出生的拉丁裔女性比NHW患者有更高的乳房X光检查使用率,突出了社区卫生中心在拉丁裔女性癌症预防护理中的重要作用。