Rural-urban differences in ductal carcinoma in situ as a proxy for mammography use over time
Rural-urban differences in ductal carcinoma in situ as a proxy for mammography use over time
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DOI：
10.1111/j.1748-0361.2003.tb00584.x
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发表时间：
2003-09-01
影响因子：
4.9
通讯作者：
Farria, D
中科院分区：
文献类型：
--
作者：
Schootman, M;Kinman, E;Farria, D
背景：从 20 世纪 80 年代初开始，随着乳房 X 光检查的使用日益增多，美国的乳腺导管原位癌 (DCIS) 发病率急剧上升。目前尚不清楚农村和城市妇女是否也经历了类似的增长。目的：描述 50 至 69 岁农村和城市女性 DCIS 发病率随时间变化的差异。这可能是乳房X线照相术用于乳腺癌早期检测的替代指标。方法：研究人群由 1973 年至 1997 年期间被诊断患有 DCIS 且居住在爱荷华州、犹他州或新墨西哥州的 50 至 69 岁女性组成。分析中使用了这些州的监测、流行病学和最终结果 (SEER) 计划的数据。当该妇女居住在被视为大都市统计区的县时，她的居住地点被归类为城市，而如果她在诊断时居住在其他地方，则她的居住地点被归类为农村。结果：农村妇女（年度百分比变化 [APC]：15.1）和城市妇女（APC：34.4）之间的增长率有所不同。 20世纪90年代，城市女性DCIS发病率仍在上升（APC：3.8），而农村女性则没有上升（APC：0.2）。还确定了这三个州农村和城市妇女之间的差异。结论：数据表明两个人群对乳房 X 光检查的使用存在差异；农村妇女的增幅较低且开始较晚。讨论了随着时间的推移造成这种差异的可能原因。
Context: With emphasis on increasing use of mammography, the rate of ductal carcinoma in situ (DCIS) of the breast has increased dramatically in the United States starting in the early 1980s. It is unclear if rural and urban women have experienced similar increases. Purpose: To describe differences in incidence of DCIS between rural and urban women 50 to 69 years of age over time. This may be a proxy indicator of mammography use for the early detection of breast cancer. Methods: The study population consisted of women 50 to 69 years of age who were diagnosed with DCIS during 1973-1997 and resided in Iowa, Utah, or New Mexico. Data from the Surveillance, Epidemiology, and End Results (SEER) programs in these states were used in the analysis. Location of the woman's residence was classified into urban when she lived in a county considered a Metropolitan Statistical Area, while she was considered rural if she resided elsewhere at the time of her diagnosis. Findings: Increases in rates were different between rural (annual percentage change [APC]: 15.1) and urban women (APC: 34.4). During the 1990s among urban women, the rate of DCIS was still increasing (APC: 3.8) while there was no increase among rural women (APC: 0.2). Differences between rural and urban women within these 3 states were also identified. Conclusions: The data suggest differences in utilization of mammography between both populations; the increase was lower and started later for rural women. Possible reasons for such differences over time are discussed.