Weinberg A D, Cooper H P, Lane M, Kripalani S
Department of Medicine, Baylor College of Medicine, Houston, TX 77030, USA.
Am J Prev Med. 1997 Jan-Feb;13(1):29-35.
Screening for breast cancer is generally underused. In an effort to remove common barriers to screening, a free breast cancer screening and education program was created for the employees of a large hospital, incorporating mammography, clinical breast examination (CBE), and breast self-examination (BSE).
The present study was conducted to evaluate the screening behaviors and long-term compliance of asymptomatic women over age 50 who participated in the program. Data were obtained from questionnaires administered at the time of enrollment (time 1) and annual reenrollment, as well as from radiology records. (Time 2 represents the most recent data.) Long-term compliance with mammography guidelines was measured by calculating a compliance quotient (CQ) for each participant.
From time 1 to time 2, subjects significantly increased their use of mammography, CBE, and BSE. At time 2, 89.5% of women had ever received a mammogram, 42.7% had gotten one in the last year, nearly all women (94.6%) had received at least one CBE, 58.0% reported annual CBE, and 44.6% of women practiced monthly BSE. CQ was higher among women who remained in the program longer, were still active in the program at the time of the study, and used screening prior to enrollment. It was also higher in Caucasians and women with a family history of breast cancer.
These results show that a worksite program that eliminates common barriers to screening can significantly increase use of early detection practices. It also demonstrates one method of quantifying long-term compliance with mammography guidelines.
乳腺癌筛查的应用普遍不足。为了消除筛查的常见障碍，为一家大型医院的员工创建了一个免费的乳腺癌筛查与教育项目，该项目纳入了乳房X光检查、临床乳房检查（CBE）和乳房自我检查（BSE）。
本研究旨在评估参与该项目的50岁以上无症状女性的筛查行为和长期依从性。数据来自入组时（时间1）和年度重新入组时发放的问卷，以及放射学记录。（时间2代表最新数据。）通过计算每位参与者的依从性商数（CQ）来衡量对乳房X光检查指南的长期依从性。
从时间1到时间2，受试者对乳房X光检查、CBE和BSE的使用显著增加。在时间2时，89.５%的女性曾接受过乳房X光检查，42.7%的女性在过去一年接受过检查，几乎所有女性（94.６%）至少接受过一次CBE，58.0%的女性报告每年进行CBE，44.6%的女性每月进行BSE。在项目中停留时间更长、在研究时仍积极参与项目且在入组前进行过筛查的女性中，CQ更高。在白种人和有乳腺癌家族史的女性中，CQ也更高。
这些结果表明，一个消除筛查常见障碍的工作场所项目可以显著增加早期检测方法的使用。它还展示了一种量化对乳房X光检查指南长期依从性的方法。
