Sarr M, Simoes E J, Murayi T, Figgs L T, Brownson R C
Mo Med. 1998 Dec;95(12):663-9.
Breast cancer is a major cause of morbidity and mortality in the United States (U.S.) and Missouri. In 1992, 3,915 new breast cancer cases were diagnosed and in 1995, 1,006 deaths from breast cancer were reported in Missouri. Although breast cancer incidence has increased in Missouri in the past 20 years, there are indications that early detection has also increased during the same period. Knowledge about which segments of the population have experienced the greatest increase in mammography screening rates helps in planning and implementation of breast cancer control programs at the state level.
Examine the prevalence and trends of lifetime mammography and 2-year mammography compliance in Missouri by age, race, and education from 1987 to 1995 and make predictions for the years 2000 and 2010.
We used data from the Missouri Behavioral Risk Factor Surveillance System (BRFSS), 1987 to 1995, to estimate the prevalence of ever having had a mammogram and compliance with mammography screening guidelines within two years by race, age, and education status among Missouri women over age 18. Using linear models, we regressed breast cancer screening prevalence estimates on time to obtain trends and predictions.
Overall, African-American women were more likely to have had a lifetime mammogram than white women. However, we found a steady increase in the prevalence of ever having had a mammogram for all groups of women defined by age and education status, except among African Americans. Increase in the prevalence of ever having had a mammogram was much higher in women age 50 and older and slightly higher among women with a high school education or less. The average prevalence of 2-year mammography screening compliance was about 60% for all groups, a rate which did not significantly change between 1987 and 1995. By the year 2000, white women will have mammography rates equal to or higher than African-American women, and the majority of all women age 50 and older (98.3% to 100%) will have had a lifetime mammogram.
Missouri target populations are predicted to attain Year 2000 National Health Objectives concerning lifetime mammography. Current efforts should be continued in order to maintain levels of mammography, particularly among African-American women.
乳腺癌是美国及密苏里州发病和死亡的主要原因。1992年，密苏里州确诊3915例新发乳腺癌病例，1995年报告有1006人死于乳腺癌。尽管在过去20年里密苏里州的乳腺癌发病率有所上升，但有迹象表明同期早期检测也有所增加。了解哪些人群的乳房X线筛查率增长幅度最大，有助于在州一级规划和实施乳腺癌控制项目。
研究1987年至1995年密苏里州按年龄、种族和教育程度划分的终生乳房X线检查患病率及两年乳房X线检查依从性趋势，并对2000年和2010年进行预测。
我们使用1987年至1995年密苏里行为风险因素监测系统（BRFSS）的数据，估算18岁以上密苏里州女性中曾进行过乳房X线检查的患病率以及两年内符合乳房X线筛查指南的情况，按种族、年龄和教育状况进行划分。使用线性模型，我们将乳腺癌筛查患病率估算值对时间进行回归以获得趋势和预测结果。
总体而言，非裔美国女性比白人女性更有可能进行过终生乳房X线检查。然而，我们发现，除了非裔美国人外，按年龄和教育状况划分的所有女性群体中，曾进行过乳房X线检查的患病率都在稳步上升。50岁及以上女性中曾进行过乳房X线检查的患病率增幅更高，高中及以下学历女性的增幅略高。所有群体两年乳房X线筛查依从性的平均患病率约为60%，这一比率在1987年至1995年间没有显著变化。到2000年，白人女性的乳房X线检查率将等于或高于非裔美国女性，所有50岁及以上女性中的大多数（98.3%至100%）将进行过终生乳房X线检查。
预计密苏里州的目标人群将实现2000年全国关于终生乳房X线检查的健康目标。应继续当前的努力，以维持乳房X线检查水平，特别是在非裔美国女性中。
