Surveillance mammography for Medicaid/Medicare breast cancer patients.
Surveillance mammography for Medicaid/Medicare breast cancer patients.
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DOI：
10.1007/s11764-009-0107-0
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发表时间：
2010-03
期刊：
影响因子：
--
通讯作者：
Dahman B
中科院分区：
文献类型：
--
作者：
Carcaise-Edinboro P;Bradley CJ;Dahman B
乳腺癌幸存者的监测乳房X光检查可以在治疗最有效的时候早期发现复发。我们评估了老年乳腺癌幸存者接受监测乳房X光检查的情况，考虑到他们的医疗补助和医疗保险双重资格和少数民族身份，这可能使他们容易受到不良监测护理的影响。我们分析了1997年至2000年期间被诊断为早期乳腺癌的66岁或以上患者的密歇根州医疗保险和医疗补助数据。使用逻辑回归和比例风险模型，我们确定了与患者接受治疗后长达3年的监测乳房X光检查的及时性相关的个人和地区层面因素。在癌症治疗后的第一年，接受保乳手术（BCS）和放疗的患者比仅接受BCS治疗的患者更可能接受监测性乳腺X线摄影（OR=1.82; 95%CI =1.48-2.24）。接受BCS和放射治疗的患者也比仅接受BCS治疗的患者更早接受监测性乳腺X线摄影的概率更大（HR=1.72; 95% CI=1.56-1.89）。老年患者（80岁以上）从治疗到乳房X线摄影的时间长于年轻患者（HR=0.55; 95% CI=0.45-0.66）和合并症负担较大的患者（HR= 0.59; 95% CI=0.43-0.81）。无论种族和双重资格，接受BCS与放射治疗的乳腺癌患者接受监测乳房X线摄影的可能性更大，并且比单独接受BCS治疗的患者更快。双重资格，黑人和老年患者不太可能接受BCS后的辐射，因此治疗和监测连续性的差异需要进一步调查。
Surveillance mammography for breast cancer survivors can detect recurrences early when treatment is most effective. We assessed the receipt of surveillance mammography for elderly breast cancer survivors considering their Medicaid and Medicare dual eligibility and minority status that may make them vulnerable to poor surveillance care. We analyzed Michigan Medicare and Medicaid data for patients, age 66 years or older, diagnosed with early stage breast cancer between 1997 and 2000. Using logistic regression and proportional hazards models, we identified individual and area level factors associated with patients’ receipt and timeliness of surveillance mammography for up to 3 years post treatment. In the first year post cancer treatment, patients who received breast conserving surgery (BCS) and radiation therapy were more likely to receive surveillance mammography than those treated with BCS alone (OR=1.82; 95% CI=1.48–2.24). Patients who received BCS and radiation treatment also had a greater probability of receiving surveillance mammography sooner than those treated with BCS alone (HR=1.72; 95% CI=1.56–1.89). Time from treatment to mammography was longer for older (80+ years) versus younger patients (HR=0.55; 95% CI=0.45–0.66) and for those with greater comorbidity burden (HR= 0.59; 95% CI=0.43–0.81). Regardless of race and dual eligibility, there is a greater likelihood for breast cancer patients who received BCS with radiation to receive surveillance mammography and to receive it sooner than for patients who were treated with BCS alone. Dual eligible, black, and elderly patients are less likely to receive radiation following BCS, thus disparities across the treatment and surveillance continuum need to be further investigated.
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影响因子：
3
作者：
Bradley, Cathy J.;Given, Charles W.;Virnig, Beth A.
通讯作者：
Virnig, Beth A.
影响因子：
7.2
作者：
Lewis, Beth G.;Halm, Ethan A.;Federman, Alex D.
通讯作者：
Federman, Alex D.
影响因子：
3.4
作者：
Randolph, WM;Mahnken, JD;Freeman, JL
通讯作者：
Freeman, JL
影响因子：
5
作者：
Kirby, James B.;Kaneda, Toshiko
通讯作者：
Kaneda, Toshiko
DOI：
10.1111/j.1532-5415.2000.tb02595.x
发表时间：
2000-10-01
影响因子：
6.3
作者：
McCarthy, EP;Burns, RB;Moskowitz, MA
通讯作者：
Moskowitz, MA