Reduced Mammography Screening for Breast Cancer among Women with Visual Impairment.
Reduced Mammography Screening for Breast Cancer among Women with Visual Impairment.
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DOI：
10.1016/j.ophtha.2020.07.029
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发表时间：
2021-02
期刊：
影响因子：
13.7
通讯作者：
Stein, Joshua D.
中科院分区：
文献类型：
--
作者：
Wu, Annie M.;Morse, Alan R.;Seiple, William H.;Talwar, Nidhi;Hansen, Sean O.;Lee, Paul P.;Stein, Joshua D.
根据美国预防服务工作组（USPSTF）的建议，及时接受乳房X光检查以筛查乳腺癌，可以大大降低发病率和死亡率。这项研究的目的是评估是否有视力障碍和没有视力障碍的妇女接受筛查性乳房X光检查的几率相似。回顾性纵向队列研究。1044名65-72岁的女性，从2008年1月1日至2015年12月31日参加了按服务收费的医疗保险。我们根据年龄、种族、医疗保险时间、居住城市和整体健康状况，将无视力丧失（NVL）、部分视力丧失（PVL）和严重视力丧失（SVL）的患者按1：1：1进行匹配。已患乳腺癌的女性被排除在外。多变量条件Logistic回归模型比较了3组在2年随访期内接受筛查性乳腺X线摄影的几率。各组接受乳腺X线摄影的比例和随访2年内接受乳腺X线摄影的校正比值比（OR）。共匹配1044例患者（每组348例）。所有3组在索引日期的平均± SD年龄为69.0 ± 1.5岁。NVL、PVL和SVL组在2年随访期内接受≥ 1次乳房X线摄影的女性比例分别为69.0%（n=240）、56.9%（n=198）和56.0%（n=195）（p=0.0005）。NVL组、PVL组和SVL组在5年期间（3年回顾期加2年随访期）每例患者接受的乳房X线照片的平均值± SD数量分别为3.1 ± 2.0、2.5 ± 2.0和2.3 ± 2.1（p<0.0001）。与NVL患者相比，SVL患者在随访期间接受乳房X线摄影的几率降低42%（OR=0.58; 95% CI：0.37-0.90，p=0.01），PVL患者在随访期间接受乳房X线摄影的几率降低44%（OR=0.56; CI：0.36-0.87，p=0.009）。有视力障碍的妇女接受乳房X光检查以筛查乳腺癌的可能性明显低于无视力障碍的妇女。临床医生应该寻找方法来帮助确保视力障碍患者接受USPSTF推荐的乳房X光检查和其他预防性筛查。与视力正常的妇女相比，视力受损的妇女根据美国预防服务工作队的指导方针接受乳房X光检查以检查乳腺癌的可能性要小得多。
Timely receipt of mammograms to screen for breast cancer in accordance with the United States Preventive Services Task Force (USPSTF) recommendations can substantially reduce morbidity and mortality. The purpose of this study is to assess whether odds of receiving screening mammograms are similar for women with and without visual impairment. Retrospective longitudinal cohort study. 1044 females, 65–72 years of age, enrolled in fee-for-service Medicare from January 1, 2008 to December 31, 2015. We matched patients with no vision loss (NVL), partial vision loss (PVL), and severe vision loss (SVL) 1:1:1 based on age, race, time in Medicare, urbanicity of residence, and overall health. Women with pre-existing breast cancer were excluded. Multivariable conditional logistic regression modeling compared the odds of receiving screening mammography within a 2-year follow-up period among the 3 groups. Proportion receiving mammography and adjusted odds ratios (OR) of receiving mammography within 2 years of follow-up among the groups. A total of 1044 patients were matched (348 in each group). The mean ± SD age at the index date was 69.0 ± 1.5 years for all 3 groups. The proportion of women receiving ≥ 1 mammogram within the 2-year follow-up period was 69.0% (n=240), 56.9% (n=198), and 56.0% (n=195) for the NVL, PVL and SVL groups, respectively (p=0.0005). The mean ± SD number of mammograms received per patient during the 5-year period (3-year look-back plus 2-year follow-up period) was 3.1 ± 2.0, 2.5 ± 2.0, and 2.3 ± 2.1 for the NVL, PVL and SVL groups, respectively (p<0.0001). Women with SVL had 42% decreased odds (OR=0.58; 95% CI: 0.37–0.90, p=0.01), and those with PVL had 44% decreased odds (OR=0.56; CI:0.36–0.87, p=0.009) of receiving mammography during the follow-up period compared to those with NVL. Women with visual impairment were significantly less likely to receive mammography to screen for breast cancer than their non-visually-impaired counterparts. Clinicians should look for ways to help ensure that patients with visual impairment receive mammograms and other preventive screenings as recommended by the USPSTF. Visually-impaired women are substantially less likely to undergo screening mammography in accordance with United States Preventive Services Task Force guidelines to check for breast cancer than their non-visually-impaired counterparts.
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影响因子：
4.8
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通讯作者：
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