Area-Level Socioeconomic Position and Repeat Mammography Screening Use: Results from the 2005 National Health Interview Survey
Area-Level Socioeconomic Position and Repeat Mammography Screening Use: Results from the 2005 National Health Interview Survey
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DOI：
10.1158/1055-9965.epi-11-0528
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发表时间：
2011-11-01
影响因子：
3.8
通讯作者：
Xu, Xiaohui
中科院分区：
文献类型：
--
作者：
Dailey, Amy B.;Brumback, Babette A.;Xu, Xiaohui
背景：尽管有相当多的研究描述了地区层面的社会经济条件和乳房x光检查之间的关系，但尚未得出明确的结论。本研究的目的是研究区域级社会经济地位（SEP）与重复乳房x光检查之间的关系，使用美国全国人口普查SEP数据，并将其与参加2005年全国健康访谈调查（NHIS）的全国代表性女性样本联系起来。方法：采用2000年美国人口普查区数据构建区域级SEP指数，并将其分为四分位数，包括失业、贫困、住房价值、家庭年收入、教育和职业等信息。重复乳房x光检查使用（二分类变量）定义为在6年（24个月间隔）内进行3次乳房x光检查，其中必须包括最近的乳房x光检查（过去2年）。对调查资料进行普通多变量logistic回归分析。年龄在46 - 79岁的女性（n = 7352）被纳入分析。结果：在一个调整了社会人口统计学、医疗保健因素和乳房x光检查筛查已知相关因素的模型中，生活在更贫困地区的妇女参与重复乳房x光检查的几率低于生活在最贫困地区的妇女[OR将四分位数4（最贫困）与四分位数1（最贫困）比较= 0.63；95%置信区间为0.50-0.80]。结论：这项全国性研究的结果支持了区域水平SEP与乳房x线摄影使用独立相关的假设。影响：这些发现强调了解决地区层面的社会不平等的重要性，如果要在所有社会阶层实现乳房x光检查指南的吸收。癌症流行病学生物标志物；20 (11);2331 - 44。(c) 2011年aacr。
Background: Despite a considerable number of studies describing the relationship between area-level socioeconomic conditions and mammography screening, definitive conclusions have yet to be drawn. The aim of this study was to examine the relationship between area-level socioeconomic position (SEP) and repeat mammography screening, using nationwide U. S. census SEP data linked to a nationally representative sample of women who participated in the 2005 National Health Interview Survey (NHIS).Methods: An area-level SEP index using 2000 U. S. census tract data was constructed and categorized into quartiles, including information on unemployment, poverty, housing values, annual family income, education, and occupation. Repeat mammography utilization (dichotomous variable) was defined as having three mammograms over the course of 6 years (24-month interval), which must have included a recent mammogram (in past 2 years). Results were obtained by ordinary multivariable logistic regression for survey data. Women ages 46 to 79 years (n = 7,352) were included in the analysis.Results: In a model adjusted for sociodemographics, health care factors, and known correlates of mammography screening, women living in more disadvantaged areas had lower odds of engaging in repeat mammography than women living in the most advantaged areas [OR comparing quartile 4 (most disadvantaged) to quartile 1 (most advantaged) = 0.63; 95% confidence interval, 0.50-0.80].Conclusion: The results of this nationwide study support the hypothesis that area-level SEP is independently associated with mammography utilization.Impact: These findings underscore the importance of addressing area-level social inequalities, if uptake of mammography screening guidelines is to be realized across all social strata. Cancer Epidemiol Biomarkers Prev; 20(11); 2331-44. (C) 2011 AACR.