Love R R, Brown R L, Davis J E, Baumann L J, Fontana S A, Sanner L A
Cancer Prevention Program, University of Wisconsin Comprehensive Cancer Center.
Arch Intern Med. 1993 Sep 27;153(18):2113-7.
Many studies reporting the frequency of breast cancer screening have been based only on physician and patient surveys or on data from quality assurance studies and do not assess the reliability of information obtained from these various sources.
To obtain more complete data we studied mammography performed in a 3-year period, 1988 through 1991, in 24 nonacademic primary care group practices by both auditing the medical records and obtaining questionnaire responses from 1819 women aged 53 to 62 years and from their 98 physicians in the nonmetropolitan Midwest.
Medical record data indicated that mammography was performed in all 3 years in 16.7%, in at least two of 3 years in 49.8%, and in at least one of 3 years in 81.7% of women. While patient reports of a family history of breast cancer, health insurance coverage for mammography, and greater annual household income were each significant predictors, a patient report that a clinic staff member had discussed mammography was the strongest predictor of greater frequency of mammography.
In this study of self-selected physicians and their patients, record-documented mammographic examinations were considerably more frequent than has been reported in some studies, but occurred at rates consistent with quality assurance data for the region. These data suggest that clinic staff initiatives with screening mammography have a large impact.
许多报告乳腺癌筛查频率的研究仅基于医生和患者的调查，或质量保证研究的数据，并未评估从这些不同来源获得的信息的可靠性。
为了获得更完整的数据，我们研究了1988年至1991年这3年期间在24个非学术性初级保健团体诊所进行的乳房X线检查，通过审核病历并从美国中西部非大都市地区的1819名53至62岁女性及其98名医生那里获得问卷调查回复。
病历数据显示，16.7%的女性在这3年中每年都进行了乳房X线检查，49.8%的女性在3年中的至少两年进行了检查，81.7%的女性在3年中的至少一年进行了检查。虽然患者报告的乳腺癌家族史、乳房X线检查的医疗保险覆盖情况以及较高的家庭年收入都是显著的预测因素，但患者报告称诊所工作人员曾讨论过乳房X线检查是乳房X线检查频率较高的最强预测因素。
在这项针对自行选择的医生及其患者的研究中，记录在案的乳房X线检查比一些研究报告的频率要高得多，但发生率与该地区的质量保证数据一致。这些数据表明诊所工作人员在筛查性乳房X线检查方面的举措有很大影响。
