Changes in the Availability of Screening Mammography, 2000-2010
Changes in the Availability of Screening Mammography, 2000-2010
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DOI：
10.1002/cncr.28305
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发表时间：
2013-11-01
期刊：
影响因子：
6.2
通讯作者：
Schrag, Deborah
中科院分区：
文献类型：
--
作者：
Elkin, Elena B.;Atoria, Coral L.;Schrag, Deborah
背景：筛查乳房X光检查的比率已经停滞不前，而乳房X光检查设备的数量在过去十年中有所下降。这项研究的目的是评估乳房X光检查服务随时间的变化和地理差异。方法根据美国食品和药物管理局和美国人口普查的信息，县级乳房X光检查能力定义为每10,000名40岁女性拥有乳房X光检查机器的数量。结果2000年至2010年，乳房X光检查设备数量从9434台下降到8469台，下降了10%；乳房X光检查机器数量从13,100台下降到11762台，中位数下降了近20%，从每万名40岁妇女中有1.77台下降到1.42台。在横断面分析中，未参保居民比例较高、受教育程度较低、人口密度较大、管理性医疗普及率较高的县的乳房X光检查能力较低。相反，每10万人口拥有更多医院床位的县有更高的产能。较高的初始乳房X光检查能力、65岁人口比例和贫困人口比例的增长，以及管理保健普及率的增加，都与2000年至2010年期间乳房X光检查能力的下降有关。只有农村居民的比例与能力的增加有关。结论乳房X光检查能力的地理差异和能力随时间的下降与人口、社会经济和医疗保健市场特征有关。乳房X光检查资源的分配不均可能解释了乳腺癌筛查率的地理差异。癌症2013；119：3847-3853。(C)2013年美国癌症协会。
BACKGROUNDRates of screening mammography have plateaued, and the number of mammography facilities has declined in the past decade. The objective of this study was to assess changes over time and geographic disparities in the availability of mammography services.METHODSUsing information from the US Food and Drug Administration and the US Census, county-level mammography capacity was defined as the number of mammography machines per 10,000 women aged40 years. Cross-sectional variation and longitudinal changes in capacity were examined in relation to county characteristics.RESULTSBetween 2000 and 2010, the number of mammography facilities declined 10% from 9434 to 8469, the number of mammography machines declined 10% from 13,100 to 11,762, and the median county mammography capacity decreased nearly 20% from 1.77 to 1.42 machines per 10,000 women aged40 years. In cross-sectional analysis, counties with greater percentages of uninsured residents, less educated residents, greater population density, and higher managed care penetration had lower mammography capacity. Conversely, counties with more hospital beds per 100,000 population had higher capacity. High initial mammography capacity, growth in both the percentage of the population aged65 years and the percentage living in poverty, and increased managed care penetration were all associated with a decrease in mammography capacity between 2000 and 2010. Only the percentage of rural residents was associated with an increase in capacity.CONCLUSIONSGeographic variation in mammography capacity and declines in capacity over time are associated with demographic, socioeconomic, and health care market characteristics. Maldistribution of mammography resources may explain geographic disparities in breast cancer screening rates. Cancer 2013;119:3847-3853. (c) 2013 American Cancer Society.