Breast Cancer Screening Beliefs, Recommendations, and Practices
Breast Cancer Screening Beliefs, Recommendations, and Practices
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DOI：
10.1002/cncr.25873
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发表时间：
2011-07-15
期刊：
影响因子：
6.2
通讯作者：
Breen, Nancy
中科院分区：
文献类型：
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作者：
Meissner, Helen I.;Klabunde, Carrie N.;Breen, Nancy
背景：初级保健医生(PCP)在乳腺癌筛查中发挥着关键作用，但目前还没有关于PCP实践的数据。方法：作者分析了2006年9月至2007年5月期间进行的一项具有全国代表性的PCP调查，以调查PCP乳腺癌筛查的信念、建议和做法。结果：在参与调查的1212名初级保健医生中，大多数(80%)报告说，为年龄=50岁的中等风险女性进行乳房X光检查在降低癌症死亡率方面非常有效，54%的人报告说，它对40岁至49岁的女性非常有效。报告临床乳房检查(CBE)或乳房自我检查(BSE)非常有效的受访者较少，但大多数人认为CBE和BSE有一定效果。大多数初级保健医生常规地向年龄=40岁的患者推荐乳房X光检查、CBE和BSE。在多因素模型中，家庭医生/全科医生(优势比[OR]，2.23；乳房摄影的95%可信区间[CI]，1.57-3.17；OR，4.42；95%CI，CBE的2.60-7.52)和内科专科医生(OR，3.21；95%CI，2.21-4.66；OR，5.34；95%CI，3.21-8.88)比妇产科医生更有可能推荐筛查的年龄上限。报告美国预防服务工作组指南非常有影响力的医生更有可能建议他们不再推荐乳房X光检查和CBE的年龄。结论：据作者所知，目前的研究是20多年来第一次报道PCP乳腺癌筛查实践的全国性研究，并为监测临床实践指南变化的影响提供了基线数据。目前的发现表明，几乎所有的初级保健医生都会常规地向年龄=40岁的患者推荐乳房X光检查、CBE和BSE，尽管建议根据初级保健专业的不同而有所不同。癌症杂志2011；117：3101-11。2011年由美国癌症协会出版*
BACKGROUND: Primary care physicians (PCPs) play a key role in breast cancer screening, yet no current data exist regarding PCP practices. METHODS: The authors analyzed a nationally representative survey of PCPs that was fielded during September 2006 to May 2007 to investigate PCP breast cancer screening beliefs, recommendations, and practices. RESULTS: Most of the 1212 PCPs who participated in the survey (80%) reported that mammography for average-risk women aged >= 50 years was very effective in reducing cancer mortality, and 54% reported that it was very effective for women ages 40 to 49 years. Fewer respondents reported that clinical breast examination (CBE) or breast self-examination (BSE) was very effective, but the majority rated CBE and BSE as somewhat effective. The majority of PCPs routinely recommended mammography, CBE, and BSE to patients aged >= 40 years. In multivariate models, family/general practitioners (odds ratio [OR], 2.23; 95% confidence interval [Cl], 1.57-3.17 for mammography; OR, 4.42; 95% Cl, 2.60-7.52 for CBE) and internal medicine specialists (OR, 3.21; 95% Cl, 2.21-4.66 for mammography; OR, 5.34; 95% Cl, 3.21-8.88 for CBE) were more likely to recommend an upper age limit for screening than obstetrician/gynecologists. Physicians who reported that US Preventive Services Task Force guidelines were very influential were more likely to recommend an age at which they no longer recommend mammography and CBE. CONCLUSIONS: To the authors' knowledge, the current study is the first national study in over 2 decades to report the breast cancer screening practices of PCPs and provides baseline data for monitoring the impact of changes in clinical practice guidelines. The current findings suggested that virtually all PCPs routinely recommend mammography, CBE, and BSE to their patients aged >= 40 years, although recommendations vary by primary care specialty. Cancer 2011;117:3101-11. Published 2011 by the American Cancer Society*