Screening for breast cancer: time, travel, and out-of-pocket expenses.
Screening for breast cancer: time, travel, and out-of-pocket expenses.
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乳腺癌筛查：时间、旅行和自付费用。
DOI：
10.1093/jnci/91.8.702
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发表时间：
1999
期刊：
影响因子：
--
通讯作者：
Detsky,AS
中科院分区：
文献类型：
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作者：
Secker-Walker,RH;Vacek,PM;Hooper,GJ;Plante,DA;Detsky,AS
背景：我们估计了被发现有乳房问题(乳腺癌或良性乳腺疾病)的女性的个人成本，包括花费的时间、旅行里程以及用于检测、诊断、初始治疗和随访的现金支付。方法：我们分析了来自佛罗里达州四个社区的465名妇女的个人访谈数据。这些妇女是从最近的乳腺活检(6-8个月内)显示乳腺癌(208名妇女)或良性乳腺疾病(257名妇女)中随机挑选出来的。一个社区是促进乳房筛查的多方面干预地点，其他三个社区是评估该干预措施的比较地点。所有P值都是双面的。结果：与乳腺良性疾病患者的治疗时间和出行距离(离家13小时，出行56英里)相比，乳腺癌患者治疗和随访所花费的时间和出行距离(小时和369英里)在统计学上显著增加(P<；.001)。女性乳腺癌患者的个人财务费用在统计上也显著较高(乳腺癌=604美元；良性乳腺疾病=76美元；P<；.001)，但在检测和诊断方面的个人财务成本显著较低(乳腺癌=170美元；良性乳腺疾病=310美元；P<；.001)。在患有乳腺癌的女性中，筛查发现乳腺癌时的治疗时间(68.9小时)显著低于因症状发现乳腺癌时的治疗时间(84.2小时)(P=0.013)。在通过筛查发现乳房问题的女性中，用于检测、诊断和治疗的个人现金支出在统计上显著低于因症状而检测到乳房问题的女性(筛查检测=453美元；检测到症状=749美元；P=.045)。结论：对于被发现有乳房问题的女性来说，无论这些成本是与筛查发现的问题有关还是与症状相关，都会产生巨大的个人成本。
BACKGROUND: We estimated the personal costs to women found to have a breast problem (either breast cancer or benign breast disease) in terms of time spent, miles traveled, and cash payments made for detection, diagnosis, initial treatment, and follow-up. METHODS: We analyzed data from personal interviews with 465 women from four communities in Florida. These women were randomly selected from those with a recent breast biopsy (within 6-8 months) that indicated either breast cancer (208 women) or benign breast disease (257 women). One community was the site of a multifaceted intervention to promote breast screening, and the other three communities were comparison sites for evaluation of that intervention. AllPvalues are two-sided. RESULTS: In comparison with time spent and travel distance for women with benign breast disease (13 hours away from home and 56 miles traveled), time spent and travel distance were statistically significantly higher (P<.001) for treatment and follow-up of women with breast cancer (89 hours and 369 miles). Personal financial costs for treatment of women with breast cancer were also statistically significantly higher (breast cancer = $604; benign breast disease = $76;P<.001) but were statistically significantly lower for detection and diagnosis (breast cancer = $170; benign breast disease = $310;P<.001). Among women with breast cancer, time spent for treatment was statistically significantly lower (P= .013) when their breast cancer was detected by screening (68.9 hours) than when it was detected because of symptoms (84.2 hours). Personal cash payments for detection, diagnosis, and treatment were statistically significantly lower among women whose breast problems were detected by screening than among women whose breast problems were detected because of symptoms (screening detected = $453; symptom detected = $749;P= .045). CONCLUSION: There are substantial personal costs for women who are found to have a breast problem, whether the costs are associated with problems identified through screening or because of symptoms.