Geographical and seasonal barriers to mammography services and breast cancer stage at diagnosis.
Geographical and seasonal barriers to mammography services and breast cancer stage at diagnosis.
复制标题
乳房X光检查服务和诊断时乳腺癌分期的地理和季节性障碍。
DOI：
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复制
发表时间：
2014
影响因子：
2.1
通讯作者：
Douglas A Miskowiak
中科院分区：
文献类型：
--
作者：
A. Onitilo;Hong Liang;Rachel V. Stankowski;J. Engel;Michael S. Broton;S. Doi;Douglas A Miskowiak
介绍
常规钼靶筛查和早期发现是乳腺癌的重要预后指标。研究了乳房X光检查服务的地理和季节障碍以及与诊断时乳腺癌分期的关系。
方法
2002年至2008年，在美国威斯康星州三级医疗诊所系统中，对1428例诊断为原发性乳腺癌的女性患者进行了回顾性研究，包括到乳腺X线检查中心的旅行时间、使用乳腺X线检查的季节分布、乳腺X线检查频率和癌症分期。
结果
在诊断前没有错过乳房X光检查的女性，距离最近的设施的中位数为15分钟，而那些错过过去五次年度乳房X光检查中的五次的女性，距离最近的设施的中位数为27分钟（p<0.0001）。到最近的乳房X线检查设施的旅行时间与诊断时的乳腺癌分期之间存在直接关系，0期和4期乳腺癌的旅行时间分别从17分钟增加到24分钟（p=0.0586）。女性在冬季接受乳房X光检查的可能性较小（p<0.0001），尤其是距离最近的乳房X光检查机构超过30英里（48.3公里）的女性（p=0.0448）。
结论
在所研究的服务区，旅行时间最近的乳房X光检查中心出现成反比关系，定期乳房X光检查筛查和乳腺癌诊断阶段。乳房X光检查在冬季不太常见，特别是在需要长途旅行的女性中。这是第一项证明冬季恶劣天气可能影响农村地区筛查行为的研究，并证明了将气候视为预防保健地理可及性的重要性。
INTRODUCTION
Routine mammography screening and early detection are important prognostic indicators for breast cancer. Geographical and seasonal barriers to mammography services and relationship to breast cancer stage at diagnosis were examined.
METHODS
Travel time to mammography center, seasonal distribution of mammogram use, mammography frequency, and stage of cancer were retrospectively examined in 1428 female patients diagnosed with primary breast cancer at a tertiary care clinic system in Wisconsin, USA, from 2002 to 2008.
RESULTS
Women with no missed mammograms before diagnosis lived a median of 15 minutes from the nearest facility, while those who missed five of their past five annual mammograms lived nearly twice as far, with a median travel time of 27 minutes (p<0.0001). There was a direct relationship between travel time to nearest mammogram facility and stage of breast cancer at diagnosis, with travel time increasing from 17 to 24 minutes for stage 0 and stage 4 breast cancers, respectively (p=0.0586). Women were less likely to undergo mammography screening during the winter months (p<0.0001), especially women with greater than 30 mi (48.3 km) to travel to the nearest mammogram facility (p=0.0448).
CONCLUSIONS
In the studied service area, travel time to nearest mammogram center appears inversely related to regular mammography screening and breast cancer stage at diagnosis. Mammograms are less common in the winter, especially in women with further to travel. This is the first study to demonstrate that inclement winter weather may impact on screening behaviors in rural areas and demonstrates the importance of considering climate as part of geographical access to preventative care.
乳腺癌筛查：时间、旅行和自付费用。
DOI：
10.1093/jnci/91.8.702
发表时间：
1999
期刊：
Journal of the National Cancer Institute
影响因子：
--
作者：
Secker-Walker,RH;Vacek,PM;Hooper,GJ;Plante,DA;Detsky,AS
通讯作者：
Detsky,AS
邮寄提醒信对乳房X光检查筛查依从性的比较有效性。
影响因子：
5.1
作者：
Romaire,MelissaA;Bowles,ErinJAiello;Anderson,MelissaL;Buist,DianaSM
通讯作者：
Buist,DianaSM