Which women aren't getting mammograms and why? (United States)
Which women aren't getting mammograms and why? (United States)
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DOI：
10.1007/s10552-006-0078-7
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发表时间：
2007-02-01
影响因子：
2.3
通讯作者：
Graubard, Barry I.
中科院分区：
文献类型：
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作者：
Meissner, Helen I.;Breen, Nancy;Graubard, Barry I.
目的 这项研究调查了为什么最近没有做过乳房 X 光检查的女性没有接受检查。 方法 使用 2000 年全国健康访谈调查 (NHIS) 的数据，我们检查了 40 岁及以上女性 (n = 10,212) 使用乳房 X 光检查的相关性，特别关注最近没有做过乳房 X 光检查的 30% (n = 3,188) 女性。非筛查是在乳房 X 光检查使用的两个重要相关因素（获得医疗保健的机会和医生建议进行乳房 X 光检查）的背景下进行检查的。 结果 总体而言，报告获得医疗保健的非筛查者中有 80% 没有收到进行乳房 X 光检查的建议。 65 岁及以上的女性比年轻女性更有可能报告没有收到建议（OR 1.77，95% CI 1.25-2.50）。对于报告有机会获得筛查的女性来说，年轻女性（40-49 岁）、教育程度较低、收入低于 20,000 美元、居住在大都市统计区 (MSA) 以外且没有乳腺癌家族史的女性不进行筛查的可能性明显更高。在存在获取问题的女性中，与曾看过初级保健提供者的女性 (46%) 相比，过去一年未曾访问过初级保健提供者的女性 (80%) 更有可能成为非筛查者。在有机会进行乳房X光检查的女性中，那些认为这是不进行筛查的主要原因的女性比那些表示不知道自己需要进行乳房X光检查的女性更年轻且出生在美国。 结论 大多数不进行乳房X光检查的女性表示没有收到医生关于进行乳房X光检查的建议。尽管少数人报告了获取途径的问题，但缺乏获取途径对利用的影响很大，并且当无法获取途径的妇女不去看医生时，这种影响会更加严重。这些发现证实了乳房X光检查建议的重要性，并提出了有关该信息是由医生传达还是由患者听到的问题。
Objective This study investigates why women who reported no recent mammogram did not get the test.Methods Using data from the 2000 National Health Interview Survey (NHIS), we examine correlates of mammography use among women 40 years and older (n = 10,212), with particular focus on the 30% (n = 3,188) who reported no recent mammogram. Non-screening is examined in the context of two important correlates of mammography use-access to health care and a physician's recommendation to get a mammogram.Results In total, 80% of non-screeners who reported having access to healthcare did not receive a recommendation for a mammogram. Women age 65 years and older were more likely than younger women to report not receiving a recommendation (OR 1.77, 95% CI 1.25-2.50). For women who reported having access, non-screening was significantly more likely among younger women (40-49), those with less education, incomes less than $20,000, residence outside Metropolitan Statistical Areas (MSAs) and no family history of breast cancer. Among women with access problems, those who had not visited a primary care provider in the past year were much more likely to be non-screeners (80%) compared with those who had seen a provider (46%). Among women with access, those who reported put it off as the main reason for non-screening were significantly more likely to be younger and to be born in the U.S. than women who said that they didn't know they needed a mammogram.Conclusions Most non-screeners report not receiving a physician recommendation for mammography. Although a minority reported access problems, the effect of lacking access on utilization was strong and is accentuated when women without access do not see a doctor. These findings confirm the importance of a mammography recommendation and raise questions concerning whether this information is being conveyed by physicians or heard by patients.