Metsch L R, McCoy C B, McCoy H V, Pereyra M, Trapido E, Miles C
Department of Epidemiology and Public Health, University of Miami School of Medicine, FL, USA.
Cancer Pract. 1998 Jul-Aug;6(4):229-36. doi: 10.1046/j.1523-5394.1998.006004229.x.
The value of mammography for asymptomatic women younger than 50 years of age has been under debate, and it had been suggested that each woman should decide for herself whether to start having mammograms in her 40s. This decision-making process requires women to have knowledge of screening guidelines. This study reported key determining informational factors that led women age 40 and older to obtain a mammogram.
To examine the relationship between sources of information and utilization of mammography, the authors conducted a communitywide telephone survey, in English and Spanish, of a stratified random sample of 999 white, black, and Hispanic women in Dade County, Florida. The survey was designed to measure knowledge, attitudes, practices, and beliefs about breast cancer, its prevention, and its early detection. Data for 784 women 40 years and older are analyzed and reported here.
The most commonly cited source of information was the media (90.2%). In a logistic regression, having had a checkup in the past year was the strongest predictor of having had a recent mammogram as opposed to a distant one (OR 4.17; 95% CI 2.92-5.95). Women who named their physician as an important source of information about health and prevention were also more likely to have had a recent examination (OR 1.85; 95% CI 1.27-2.69).
This analysis of the relationship between the source of information and utilization of mammography suggests that physicians, as sources of information, serve to motivate women to obtain a mammogram. This is true even after taking into account the patient's age and utilization of the healthcare system for preventive care in general. For this reason, it is imperative that clinicians be aware of national guidelines for breast cancer screening; of the risks and benefits of screening measures; and of the implications of a positive and negative test result. In addition, clinicians must realize the importance of follow-up to remind the patient to obtain a mammogram or other screening test and should develop strategies to provide this service.
乳腺钼靶检查对50岁以下无症状女性的价值一直存在争议,有人建议每位女性应自行决定是否在40多岁时开始进行乳腺钼靶检查。这一决策过程要求女性了解筛查指南。本研究报告了促使40岁及以上女性进行乳腺钼靶检查的关键决定性信息因素。
为了研究信息来源与乳腺钼靶检查利用率之间的关系,作者对佛罗里达州戴德县999名白人、黑人和西班牙裔女性进行了分层随机抽样的全社区电话调查,调查使用英语和西班牙语。该调查旨在衡量关于乳腺癌、其预防及早期检测的知识、态度、做法和信念。本文分析并报告了784名40岁及以上女性的数据。
最常被提及的信息来源是媒体(90.2%)。在逻辑回归分析中,过去一年进行过体检是近期进行过乳腺钼靶检查而非很久以前进行过的最强预测因素(比值比4.17;95%置信区间2.92 - 5.95)。将医生视为健康和预防重要信息来源的女性近期进行检查的可能性也更大(比值比1.85;95%置信区间1.27 - 2.69)。
对信息来源与乳腺钼靶检查利用率之间关系的这一分析表明,医生作为信息来源,有助于促使女性进行乳腺钼靶检查。即使考虑到患者的年龄以及总体上利用医疗保健系统进行预防性护理的情况,也是如此。因此,临床医生必须了解乳腺癌筛查的国家指南;筛查措施的风险和益处;以及阳性和阴性检测结果的影响。此外,临床医生必须认识到随访提醒患者进行乳腺钼靶检查或其他筛查检测的重要性,并应制定提供此项服务的策略。