Health maintenance and screening in breast cancer survivors in the United States
Health maintenance and screening in breast cancer survivors in the United States
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DOI：
10.1016/j.cdp.2005.06.012
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发表时间：
2006-01-01
影响因子：
--
通讯作者：
Allsworth, JE
中科院分区：
文献类型：
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作者：
Duffy, CM;Clark, MA;Allsworth, JE
背景：乳腺癌幸存者的一般健康维护和随访尚未得到充分研究。在基于人群的样本中，我们试图调查乳腺癌幸存者的健康习惯，并比较与无乳腺癌病史的女性的筛查率。方法：对象是1996年和1998年医疗支出调查的参与者，这些年份有筛查信息。我们使用了匹配的队列设计。将 40 岁及以上的乳腺癌幸存者（在年龄和种族/民族方面）与没有乳腺癌病史的女性进行匹配。我们进行逻辑回归来估计乳腺癌幸存者与无乳腺癌病史的女性接受适当医疗保健服务的几率。此外。我们研究了报告适当筛查的乳腺癌幸存者和筛查不充分的乳腺癌幸存者之间的人口和社会经济差异。结果：一小部分乳腺癌幸存者报告乳房 X 光检查 (18%) 和临床乳房检查 (12%) 随访不足。很大一部分乳腺癌幸存者报告子宫颈抹片检查筛查不足（40%）。一般体检 (GPE) (30%) 和流感疫苗 (33%)。与匹配的女性相比，幸存者接受乳房X光检查、临床乳房和胆固醇筛查的适当筛查的几率更高。其他筛查没有差异。涵盖所有健康维护和筛查实践。未接受适当筛查的乳腺癌幸存者拥有私人保险、结婚和高于平均收入水平的可能性较小，尽管这些差异并不显着。结论：尽管幸存者报告筛查水平较高，但少数女性报告乳房 X 光检查和临床乳房检查随访不足，考虑到她们复发和第二原发性乳腺癌的风险，这一点令人担忧。此外，很大一部分幸存者报告对一般健康维护问题的筛查不足。人口统计和社会经济因素与较低的筛查率相关。然而，与普通人群中的女性相比，乳腺癌幸存者的筛查缺陷似乎较小。 (c) 2005 年国际预防肿瘤学会。由爱思唯尔有限公司出版。保留所有权利。
Background: The general health maintenance and follow-up of breast cancer survivors has not been well-studied. In a population-based sample we sought to investigate the health practices of breast cancer survivors and to compare rates of screening to women with no history of breast cancer. Methods: Subjects were participants of the medical expenditure survey in the years 1996 and 1998. years for which information on screening were available. We used a matched cohort design. Breast cancer survivors aged 40 and older were matched (on age and race/ ethnicity) to women with no breast cancer history. We performed logistic regression to estimate the odds of receiving appropriate health care services in breast cancer survivors versus women with no breast cancer history. In addition. we examined demographic and socioeconomic differences between breast cancer survivors who reported appropriate screening and survivors who had inadequate screening. Results: A small minority of breast cancer survivors report inadequate mammography (18%) and clinical breast exam (12%) follow-up. A significant portion of breast cancer survivors report inadequate screening for Pap smear (40%). general physical exam (GPE) (30%) and flu shot (33%). The odds of receiving appropriate screening were higher in survivors versus matched women for mammography, clinical breast and cholesterol screening. There were no differences for other screening. Across all health maintenance and screening practices. breast cancer survivors who did not receive appropriate screening were less likely to have private insurance, to be married and to be above the mean income level, though these differences were non-significant. Conclusions: Although survivors report high levels of screening, a small minority of women report inadequate mammography and clinical breast exam follow-up which is concerning given their risk of recurrence and second primary breast cancer. Additionally, a significant portion of survivors report inadequate screening for general health maintenance issues. Demographic and socioeconomic factors were associated with lower screening rates. However, the deficits in screening among breast cancer survivors appears to be smaller compared to women in the general population. (c) 2005 International Society for Preventive Oncology. Published by Elsevier Ltd. All rights reserved.