Impact of the National Breast and Cervical Cancer Early Detection Program on mammography and pap test utilization among white, hispanic, and African American women: 1996-2000
Impact of the National Breast and Cervical Cancer Early Detection Program on mammography and pap test utilization among white, hispanic, and African American women: 1996-2000
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DOI：
10.1002/cncr.22353
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发表时间：
2007-01-15
期刊：
影响因子：
6.2
通讯作者：
Joski, Peter J.
中科院分区：
文献类型：
--
作者：
Adams, E. Kathleen;Breen, Nancy;Joski, Peter J.
预防，包括常规癌症筛查，是实现消除癌症死亡和痛苦的国家目标的关键。自1991年以来，美国政府投资于国家乳腺癌和宫颈癌早期检测计划（NBCCEDP）等项目，以在未投保的低收入妇女中早期检测乳腺癌和宫颈癌。一个伴随的目标是减少筛查和早期发现中的种族差异，NBCCEDP计划的目标是低收入妇女，她们往往是少数种族和民族。本文分析了数据，以测试NBCCEDP的影响和其他决定因素的筛选跨种族/民族群体。我们使用了1996年至2000年行为风险因素监测系统（BRFSS）的数据。这些数据表明，年龄在40-64岁的非裔美国人和非西班牙裔白色妇女之间在乳腺癌和宫颈癌检测方面的差距已经缩小，但西班牙裔妇女仍然存在。多变量研究结果表明，通过NBCCEDP免费筛查网站的寿命显着增加了非西班牙裔白色妇女的两种测试。数据没有证实其他种族和族裔群体的这种影响。分析确实表明，公共保险或医疗补助在促进非裔美国人和西班牙裔美国人增加检测方面与私人保险相等，但对非西班牙裔白人则不然。确保医疗补助仍然适用于这一非老年群体中的妇女，并增加免费筛查网站的使用，可以使我们更接近国家筛查目标，但政策仍然需要解决保险和服务提供方面的种族/民族差异。
Prevention, including routine cancer screening, is key to meeting national goals for the elimination of death and suffering due to cancer. Since 1991, the U.S. government has invested in programs such as the National Breast and Cervical Cancer Early Detection Program (NBCCEDP) to detect breast and cervical cancer early among uninsured low-income women. A concomitant goal is reducing racial disparities in screening and early detection, and the NBCCEDP program targets low income women who are more often racial and ethnic minorities. This paper analyzes data to test for effects of the NBCCEDP and other determinants of screening across racial/ethnic groups. We used data from the Behavioral Risk Factor Surveillance System (BRFSS) for 1996 through 2000. These data indicate that gaps in testing for breast and cervical cancers between African American and non-Hispanic white women aged 40-64 years have closed but remain for Hispanics. Multivariate findings indicate that the longevity of free screening sites through the NBCCEDP significantly increased both tests for non-Hispanic white women. The data do not confirm this effect for other racial and ethnic groups. Analysis did indicate that public insurance, or Medicaid, was equal to private insurance in promoting increased testing for African Americans and Hispanics, but not for non-Hispanic whites. Assuring that Medicaid remains available for women in this nonelderly group and increasing access to free screening sites can lead us closer to national screening goals, yet policies still need to address racial/ethnic disparities in insurance and service delivery.