MAMMOGRAPHY ADHERENCE AND PSYCHOLOGICAL DISTRESS AMONG WOMEN AT RISK FOR BREAST-CANCER
MAMMOGRAPHY ADHERENCE AND PSYCHOLOGICAL DISTRESS AMONG WOMEN AT RISK FOR BREAST-CANCER
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DOI：
10.1093/jnci/85.13.1074
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发表时间：
1993-07-07
期刊：
影响因子：
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通讯作者：
ENGSTROM, P
中科院分区：
文献类型：
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作者：
LERMAN, C;DALY, M;ENGSTROM, P
背景资料：以前的研究估计，乳腺癌患者的一级亲属患乳腺癌的风险增加了2倍到10倍。最近，人们的注意力集中在乳腺癌高危妇女的乳房X光检查实践上。目的：我们的目的是在乳腺癌患者的一级亲属样本中描述乳房X线摄影筛查实践的特征，并确定可能成为坚持乳房X线摄影的障碍或促进因素的变量。研究方法：通过电话采访收集了140名年龄在35-79岁之间的女性的横断面（而不是前瞻性）数据，这些女性至少有一个一级亲属（母亲，姐妹或女儿）有乳腺癌家族史。记录了有关乳房X光检查筛查模式、抑郁症、压力影响和乳腺癌担忧的数据。结果如下：乳腺X线摄影史符合特定年龄建议的女性因年龄而异：76%的一级亲属年龄在35-39岁，86%的年龄在40-49岁，63%的年龄在50岁或以上。在双变量分析中，受教育程度（P = 0.001）、就业（P = 0.046）和索引患者自诊断以来的时间（P = 0.044）与乳腺X线检查依从性显著正相关。与依从性呈负相关的变量包括年龄（P = 0.019），对乳腺癌的侵入性想法（P = 0.042）和干扰日常功能的乳腺癌担忧（P = 0.004）。Logistic回归多因素分析显示，只有担心患乳腺癌（OR = 2.5，95%可信区间（CI）= 1.09-5.9）和受教育程度（OR = 4.8，CI = 1.6-14.3）是乳腺X线摄影依从性的独立预测因素。结论：这项研究表明，大多数乳腺癌高危妇女坚持国家癌症研究所推荐的乳房X光检查筛查指南。然而，50岁及以上的高风险女性的依从率并不理想;这些女性中只有63%接受了年度筛查乳房X线检查，13%从未接受过筛查。对乳腺癌的担忧可能会阻碍高危女性坚持乳房X光检查，特别是那些受正规教育较少的女性。含义：需要前瞻性的纵向研究来验证目前的研究结果，并评估心理教育干预的影响与受影响的一级亲属的妇女。
Background: Previous studies estimate that first-degree relatives of women with breast cancer have a twofold to 10-fold increased risk of developing breast cancer. Recently, attention has focused on the mammography screening practices of women who are at high risk for breast cancer. Purpose: Our purpose was to characterize mammography screening practices in a sample of first-degree relatives of breast cancer patients and to identify variables that may serve as barriers to or facilitators of adherence to mammography. Methods: Cross-sectional (rather than prospective) data were collected by telephone interviews with 140 women aged 35-79 years who had a family history of breast cancer in at least one first-degree relative (mother, sister, or daughter). Data were recorded on mammography screening patterns, depression, stress impact, and breast cancer worries. Results: Women whose mammography history adhered to age-specific recommendations varied by age: 76% of first-degree relatives aged 35-39 years, 86% aged 40-49 years, and 63% aged 50 years or more. In bivariate analyses, level of education (P = .001), employment (P = .046), and time since diagnosis of the index patient (P = .044) were significantly and positively associated with mammography adherence. Variables associated negatively with adherence included age (P = .019), intrusive thoughts about breast cancer (P = .042), and breast cancer worries that interfered with daily functioning (P = 004). MultivariAte analysis by logistic regression indicated that only breast cancer worries (odds ratio [OR] = 2.5; 95% confidence interval [CI] = 1.09-5.9) and education (OR = 4.8; CI = 1.6-14.3) were significant independent predictors of mammogaphy adherence. Conclusions: This study suggests that most women at high risk for breast cancer adhere to the recommended mammography screening guidelines of the National Cancer Institute. However, rates of adherence among high-risk women aged 50 years and older are suboptimal; only 63% of these women received annual screening mammograms, and 13% had never been screened. Breast cancer worries may pose a barrier to mammography adherence among high-risk women, particularly those with less formal education. Implications: Prospective longitudinal studies are needed to validate the present findings and to evaluate the impact of psychoeducational interventions for women with affected first-degree relatives.