Norman S A, Weinberg G B, Krampe B R, Finnegan E T
Center for Clinical Epidemiology and Biostatistics, University of Pennsylvania, Philadelphia 19104.
Public Health Rep. 1993 May-Jun;108(3):395-401.
The use of local data on cancer incidence and mortality and on risk-related behaviors to help communities set priorities and guide program planning is an important facet of the National Cancer Institute's Program, "Data-Based Intervention Research for Public Health Agencies." As a participant in this program, the Pennsylvania Department of Health has developed a "breast cancer profile" for a seven-county, predominantly rural region of northwestern Pennsylvania. Community hospitals in the area are collaborating with the health department to develop interventions to enhance screening mammography. The availability of the profiles allowed hospitals to compare local breast cancer risk and screening activities with those of the State and nation, to target interventions, and to establish a baseline to measure changes over time. The data generated great interest among health professionals in northwestern Pennsylvania because, contrary to their expectations, the region was quite similar to the State and nation. While the proportion of women ages 40 and older who had ever had a mammogram was relatively high (66 percent), the proportion with more than one mammogram was considerably lower (43 percent), suggesting that hospitals focus on promoting regular mammography. Although it is feasible to develop data-based interventions for local areas, the effort is not trivial. State and national agencies must cooperate to ensure comparability of data collection and reports so that comparisons of local, State, and national data can be produced routinely.
利用关于癌症发病率、死亡率以及与风险相关行为的本地数据，来帮助社区确定工作重点并指导项目规划，是美国国立癌症研究所“公共卫生机构基于数据的干预研究”项目的一个重要方面。作为该项目的参与者，宾夕法尼亚州卫生部为宾夕法尼亚州西北部一个以农村为主的七县地区编制了一份“乳腺癌概况”。该地区的社区医院正在与卫生部门合作，制定干预措施以提高乳腺钼靶筛查率。这些概况的提供使医院能够将当地的乳腺癌风险和筛查活动与该州及全国的情况进行比较，确定干预目标，并建立一个基线来衡量随时间的变化。这些数据引起了宾夕法尼亚州西北部卫生专业人员的极大兴趣，因为与他们的预期相反，该地区与该州及全国的情况相当相似。虽然40岁及以上曾经接受过乳腺钼靶检查的女性比例相对较高（66%），但接受过不止一次乳腺钼靶检查的比例则相当低（43%），这表明医院应专注于促进定期乳腺钼靶检查。虽然为当地地区制定基于数据的干预措施是可行的，但这项工作并非轻而易举。州和国家机构必须合作，以确保数据收集和报告的可比性，以便能够定期对地方、州和国家数据进行比较。
