Timeliness of Breast Cancer Diagnosis and Initiation of Treatment in the National Breast and Cervical Cancer Early Detection Program, 1996-2005
Timeliness of Breast Cancer Diagnosis and Initiation of Treatment in the National Breast and Cervical Cancer Early Detection Program, 1996-2005
复制标题
DOI：
10.2105/ajph.2009.160184
复制
发表时间：
2010-09-01
影响因子：
12.7
通讯作者：
Benard, Vicki B.
中科院分区：
文献类型：
--
作者：
Richardson, Lisa C.;Royalty, Janet;Benard, Vicki B.
目标.为了确定计划政策变化的影响，我们研究了国家乳腺癌和宫颈癌早期检测计划（NBCCEDP）中乳腺癌筛查的服务提供基准。我们分析了NBCCEDP数据的妇女异常乳房X线或临床乳腺检查（n = 382416），其中23701癌症被诊断。我们研究了两个时间段的诊断和治疗时间：1996年至2000年和2001年至2005年。我们用Kruskal-Wallis检验比较了诊断、治疗开始和总间期的中位时间。我们用逻辑回归计算调整比例（预测边缘值），以检查诊断和治疗在程序基准（60天）和从筛选到治疗的时间（120天）内。中位诊断间隔时间缩短了2天（25 vs 23; P < .001）。中位治疗开始间隔时间增加了2天（12 vs 14; P < .001）。总间期缩短了3天（43 vs 40; P < .001）。符合60天诊断基准的妇女在乳房X线检查正常和临床乳房检查异常的妇女中改善最多，从77%提高到82%。通过NBCCEDP筛查的妇女接受诊断随访，并在预先制定的计划指南内开始治疗。(Am J公共卫生。2010;100：1769-1776. doi：10.2105/AJPH.2009.160184）
Objectives. To determine the effects of program policy changes, we examined service delivery benchmarks for breast cancer screening in the National Breast and Cervical Cancer Early Detection Program (NBCCEDP).Methods. We analyzed NBCCEDP data for women with abnormal mammogram or clinical breast examination (n = 382416) from which 23701 cancers were diagnosed. We examined time to diagnosis and treatment for 2 time periods: 1996 to 2000 and 2001 to 2005. We compared median time for diagnostic, treatment initiation, and total intervals with the Kruskal-Wallis test. We calculated adjusted proportions (predicted marginals) with logistic regression to examine diagnosis and treatment within program benchmarks (60 days) and time from screening to treatment (120 days).Results. Median diagnostic intervals decreased by 2 days (25 vs 23; P < .001). Median treatment initiation intervals increased by 2 days (12 vs 14; P < .001). Total intervals decreased by 3 days (43 vs 40; P < .001). Women meeting the 60-day benchmark for diagnosis improved the most for women with normal mammograms and abnormal clinical breast examinations from 77% to 82%.Conclusions. Women screened by the NBCCEDP received diagnostic follow-up and initiated treatment within preestablished program guidelines. (Am J Public Health. 2010;100:1769-1776. doi:10.2105/AJPH.2009.160184)