Nationwide cross-sectional adherence to mammography screening guidelines: national behavioral risk factor surveillance system survey results
Nationwide cross-sectional adherence to mammography screening guidelines: national behavioral risk factor surveillance system survey results
复制标题
DOI：
10.1007/s10549-017-4286-5
复制
发表时间：
2017-08-01
影响因子：
3.8
通讯作者：
Harvey, Susan
中科院分区：
文献类型：
--
作者：
Narayan, Anand;Fischer, Alexander;Harvey, Susan
关于乳腺癌筛查的各种建议引起了人们对何时以及多久进行一次乳房X光检查的困惑，然而，关于患者在多大程度上遵守各种乳房X光检查指南的实际情况，基于人群的数据有限。我们的目的是使用主要指南编制组织的标准来评估基于人群对乳房X光检查的遵守情况。2014年行为风险因素监测系统调查中年龄在40-74岁的女性被纳入其中。根据主要的指南编制组织(美国癌症协会[ACS]、美国预防服务工作组[USPSTF]、美国放射学会[ACR]、美国妇产科医师学会[ACOG])，在1到2年内进行自我报告的乳房X光检查，采用Logistic回归计算，并根据人口统计学和获得卫生保健的指数进行调整。按年龄分类，符合USPSTF指南的横断面比例为76-81%，对急性冠脉综合征(55-81%)和ACR/ACOG(45-%)的依从性随年龄增加而提高。接受乳房X光检查的女性比例最高的是65-69岁的女性(去年为66%，近两年为81%)。统计学上有意义的预测因素包括收入增加(OR1.08，1.07-1.09)、受教育程度高(OR1.13，1.11-1.16)和更容易获得医疗保健(OR2.25，1.94-2.60)。坚持接受乳房X光检查最接近USPSTF指南，横断面符合76%-81%。筛查频率随着年龄的增长而增加，65-69岁的妇女筛查比例最高(去年为66%，最近两年为81%)。对于所有筛查指南，在获得医疗保险的机会有限的妇女中，遵守乳房X光检查的情况仍然很差，只有不到一半的妇女获得了推荐的筛查。
Varying recommendations about breast cancer screening have generated much confusion about when and how often to undergo mammography screening, yet there is limited population-based data about the extent to which patients adhere to various mammographic screening guidelines in practice. Our purpose was to evaluate population-based adherence to mammographic screening using criteria from major guideline-producing organizations.Women aged 40-74 in the 2014 Behavioral Risk Factor Surveillance System survey were included. Self-reported mammographic screening within 1 or 2 years, according to major guideline-producing organizations (American Cancer Society [ACS], US Preventative Services Task Force [USPSTF], American College of Radiology [ACR], American College of Obstetricians and Gynecologists [ACOG]) was calculated with logistic regression, adjusting for demographics and indices of access to health care.159,123 women were included. By age category, cross-sectional adherence to USPSTF guidelines ranged from 76 to 81%, ACS (55-81%) and ACR/ACOG (45-64%) with increasing age being associated improved adherence. The highest proportions of women undergoing mammographic screening were seen in women ages 65-69 (66% within last year, 81% within last 2 years). Statistically significant predictors of adherence to mammography screening included increased income category (OR 1.08, 1.07-1.09), higher education category (OR 1.13, 1.11-1.16), and increased access to health care (OR 2.25, 1.94-2.60), adjusted for age categories.Adherence to mammography screening was closest to USPSTF guidelines with 76-81% cross-sectional adherence. Frequency of screening increases with age with highest screening proportions in women ages 65-69 (66% within last year, 81% within last 2 years). For all screening guidelines, adherence to mammography screening remains poor in women with limited access to health insurance with less than half of women obtaining recommended screening.