A community effort to reduce the black/white breast cancer mortality disparity in Chicago
A community effort to reduce the black/white breast cancer mortality disparity in Chicago
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DOI：
10.1007/s10552-009-9419-7
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发表时间：
2009-11-01
影响因子：
2.3
通讯作者：
Marcus, Elizabeth
中科院分区：
文献类型：
--
作者：
Ansell, David;Grabler, Paula;Marcus, Elizabeth
背景 芝加哥大都会乳腺癌工作组的成立是为了解决芝加哥日益扩大的黑人/白人乳腺癌死亡率差异。该工作组探讨了三个假设：芝加哥黑人妇女接受的乳房 X 光检查较少，黑人妇女接受的乳房 X 光检查质量较差，黑人妇女无法充分获得高质量的乳腺癌治疗。方法 2007 年 1 月至 9 月，来自 74 个芝加哥地区组织的总共 102 名个人参加了工作组，参加了三个工作组。工作组举行了医疗服务提供者焦点小组会议，在芝加哥的四个社区组织了市政厅会议，收集了美国芝加哥和新墨西哥州的黑人/白人乳腺癌死亡率数据。约克市，并对乳房X光检查设施进行了乳房X光检查能力和质量调查。结果芝加哥的黑人和白人乳腺癌死亡率在1980年是相同的。到了90年代末，出现了很大的差距，到2005年，黑人乳腺癌死亡率比白人高出116%。 2007年，芝加哥为居住在芝加哥的女性进行了206,000例乳房X光检查，远远低于芝加哥40-69岁年龄段女性的588,000例。主要服务于少数族裔女性的设施不太可能是学术或私人机构 (p < 03)，不太可能拥有数字乳房 X 光检查 (p < 003)，也不太可能有专门的乳腺成像专家阅读胶片 (p < 003)。黑人妇女和为她们服务的提供者报告说，在获得乳腺癌筛查和治疗所需的护理方面存在很大困难。 结论 获得高质量乳房 X 光检查和治疗服务存在重大障碍，这可能会导致芝加哥的死亡率差异。已经成立了一个大都市范围的工作组来解决这一差距。
Background The Metropolitan Chicago Breast Cancer Taskforce was formed to address a growing black/white breast cancer mortality disparity in Chicago. The Taskforce explored three hypotheses: black women in Chicago receive fewer mammograms, black women receive mammograms of inferior quality, and black women have inadequate access to quality of treatment for breast cancer.Methods A total of 102 individuals from 74 Chicago area organizations participated in the Task Force participating in three work groups from January to September 2007. The work groups held focus groups of providers, organized town hall meetings in four Chicago communities, gathered black/white breast cancer mortality data for Chicago, the United States, and New York City, and conducted a mammography capacity and quality survey of mammography facilities.Results Chicago's black and white breast cancer mortality rates were the same in 1980. By the late 1990s, a substantial disparity was present, and by 2005, the black breast cancer mortality rate was 116% higher than the white rate. In 2007, 206,000 screening mammograms were performed for women living in Chicago, far short of the 588,000 women in the 40-69 age range in Chicago. Facilities that served predominately minority women were less likely to be academic or private institutions (p < 03), less likely to have digital mammography (p < 003), and less likely to have dedicated breast imaging specialists reading the films (p < 003). Black women and providers serving them reported significant difficulties in accessing needed care for breast cancer screening and treatment.Conclusion There are significant access barriers to high quality mammography and treatment services that could be contributing to the mortality differences in Chicago. A metropolitan wide taskforce has been established to address the disparity.