Factors associated with mammography use: A side-by-side comparison of results from two national surveys
Factors associated with mammography use: A side-by-side comparison of results from two national surveys
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DOI：
10.1002/cam4.3128
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发表时间：
2020-07-17
期刊：
影响因子：
4
通讯作者：
Liu, Bian
中科院分区：
文献类型：
--
作者：
Li, Lihua;Ji, Jiayi;Liu, Bian
乳腺X线摄影的使用受到多种因素的影响，这些因素可能随着公共卫生干预措施的实施而发生变化。我们检查了两项具有全国代表性的基于人群的调查，以寻求共识，并确定与美国整体人群以及黑人和白色亚组使用乳腺X射线摄影相关的因素的不一致性。方法分别从2016年全国健康访谈调查（NHIS）和2016年行为风险因素监测系统（BRFSS）中提取了12 639名和169 116名40-74岁女性在过去一年中自我报告的乳房X线检查使用情况。我们应用随机森林算法来识别乳腺X射线摄影使用的风险因素，并在多变量调查logistic回归中使用其中的一个子集来检查它们与乳腺X射线摄影使用的相关性，报告预测范围和效应大小。结果过去一年使用乳腺X线摄影的加权患病率在调查中具有可比性：NHIS中总体为54.31%，白色为54.50%，黑人为61.57%; BRFSS中总体为53.24%，白色为56.97%，黑人为62.11%。总体而言，乳房X光检查的使用与黑人种族、年龄较大、收入较高和有医疗保险呈正相关，而与家中有三个或更多孩子和居住在美国西部地区呈负相关。超重和中度肥胖与黑人女性（NHIS）乳房X线摄影使用的增加显著相关，而重度肥胖与白色女性（BRFSS）乳房X线摄影使用的减少显著相关。结论：我们发现黑人女性比白色女性使用乳腺X线摄影的比例更高，这是历史趋势的一个变化。我们还将高产次确定为使用乳房X光检查的风险因素，这表明潜在的亚群可以通过旨在增加乳房X光检查使用的干预措施来瞄准。
Background Mammography use is affected by multiple factors that may change as public health interventions are implemented. We examined two nationally representative, population-based surveys to seek consensus and identify inconsistencies in factors associated with mammography use in the entirety of the US population, and by black and white subgroups. Methods Self-reported mammography use in the past year was extracted for 12 639 and 169 116 women aged 40-74 years from the 2016 National Health Interview Survey (NHIS) and the 2016 Behavioral Risk Factor Surveillance System (BRFSS), respectively. We applied a random forest algorithm to identify the risk factors of mammography use and used a subset of them in multivariable survey logistic regressions to examine their associations with mammography use, reporting predictive margins and effect sizes. Results The weighted prevalence of past year mammography use was comparable across surveys: 54.31% overall, 54.50% in white, and 61.57% in black in NHIS and 53.24% overall, 56.97% in white, and 62.11% in black in BRFSS. Overall, mammography use was positively associated with black race, older age, higher income, and having health insurance, while negatively associated with having three or more children at home and residing in the Western region of the US. Overweight and moderate obesity were significantly associated with increased mammography use among black women (NHIS), while severe obesity was significantly associated with decreased mammography use among white women (BRFSS). Conclusion We found higher mammography use among black women than white women, a change in the historical trend. We also identified high parity as a risk factor for mammography use, which suggests a potential subpopulation to target with interventions aimed at increasing mammography use.