Fox S A, Roetzheim R G
RAND, Santa Monica, CA 90407-2138.
Cancer. 1994 Oct 1;74(7 Suppl):2028-33. doi: 10.1002/1097-0142(19941001)74:7+<2028::aid-cncr2820741707>3.0.co;2-6.
Little is known about the screening behavior of older minority women, especially Hispanic women. Data from Los Angeles were compared to national data to examine any similarities and unique problems.
In 1990, 726 women from Los Angeles older than 65 years of age were surveyed by telephone after being identified through a probability sample or through Medicare listings. Mammography experience and knowledge and attitudes about screening were collected. Differences in mammography experience by racial/ethnic group were computed using the chi-square test.
Hispanic women were not underscreened significantly compared with older white and black women. Approximately three quarters of Hispanics had had a mammogram in the previous 2 years, compared with 84% of blacks and 82% of whites. Income and education levels were more explanatory of underscreening than was race. For example, 50% of whites with incomes of less than $15,000 had been screened in the previous 2 years, compared with 71% of those with higher incomes. Hispanics, however, reported significantly more concerns about screening and getting breast cancer than did whites or blacks despite the Hispanics' lower incidence and mortality rates. Hispanics also reported more health insurance inadequacies and a poorer quality of life that may interfere with maintenance of screening behaviors.
To maintain equal screening across racial/ethnic groups, national programs should focus on strategies that help Hispanics acculturate to achieve equal educational and other benefits. To decrease screening inequities within races and help realize the National Cancer Institute's Year 2000 goals, income and educational differences will need to be less pronounced.
对于老年少数族裔女性,尤其是西班牙裔女性的筛查行为,我们知之甚少。将洛杉矶的数据与全国数据进行比较,以研究其中的相似之处和独特问题。
1990年,通过概率抽样或医疗保险清单识别出726名年龄超过65岁的洛杉矶女性,并对她们进行电话调查。收集她们的乳房X光检查经历以及对筛查的知识和态度。使用卡方检验计算不同种族/族裔群体在乳房X光检查经历上的差异。
与老年白人和黑人女性相比,西班牙裔女性的筛查率并没有显著偏低。在过去两年中,约四分之三的西班牙裔女性进行过乳房X光检查,相比之下,黑人女性的这一比例为84%,白人女性为82%。收入和教育水平比种族更能解释筛查率偏低的情况。例如,收入低于15,000美元的白人女性中,有50%在过去两年中接受过筛查,而收入较高的白人女性这一比例为71%。然而,尽管西班牙裔女性的发病率和死亡率较低,但她们报告称比白人和黑人更担心筛查和患乳腺癌。西班牙裔女性还报告称,她们的医疗保险不足,生活质量较差,这可能会影响她们维持筛查行为。
为了在不同种族/族裔群体中保持平等的筛查率,国家项目应侧重于帮助西班牙裔女性融入文化以获得平等教育和其他福利的策略。为了减少种族内部的筛查不平等并帮助实现国家癌症研究所2000年的目标,需要缩小收入和教育方面的差距。