NEW HANOVER BREAST CANCER SCREENING PROGRAM

我们提出了一个全面的计划，以增加和改善 乳腺癌筛查（BCS），包括年度临床乳腺癌筛查 在50至74岁的妇女中， 北卡罗来纳州新汉诺威县。 该计划将由一个 当地医学领导和项目研究者委员会。 干预措施将针对1）初级保健医生，2） 放射科医生，3）50至74岁的社区妇女。 为 医生，一个教育会议，重点是需要 乳房X光检查，培训课程，以提高性能的 临床乳房检查，并采用提示系统 提醒医生进行BCS。 UNC 放射科医生将与当地放射科医生合作， 乳腺X线摄影的质量保证系统。 放射科医生和 当地医疗领导将努力使高质量的 乳房X光检查收费较低。 最后，一个社区 发明将提高妇女对BCS的认识和使用， 大众媒体宣传运动。 此外，一个病人激励计划， 使用书面材料（小册子，海报和卡片）将提醒 患者向医生询问BCS的情况。 每个 干预措施将以模块化方式制定， 有用的，它可以在全国各地的其他社区使用。 评估将包括测试前和测试后的测量， 汉诺威县和对照社区，皮特县：1）A 对50至74岁的妇女进行电话调查， 在过去一年中获得BCS的百分比; 2）A 对医生进行电话调查，以确定知识/态度 乳腺肿块检测能力评估 医生使用人造硅胶乳房模型; 4） 审查病历以确定BCS的频率， 医生的做法; 5）记录的数量和费用， 进行的乳房X光检查和质量的存在/程度 放射科乳房X光检查的保证;以及6）审查 当地医院病理报告，以记录病理 所有新诊断的乳腺癌的分期。

We propose a comprehensive program to increase and improve breast cancer screening (BCS), including annual clinical breast examination and mammography among women ages 50 to 74 in New Hanover County, NC. The program will be coordinated by a committee of local medical leaders and the project investigators. Interventions will be aimed at 1) Primary Care Physicians, 2) Radiologists, and 3) Community Women ages 50 to 74. For physicians, an educational meeting focusing on the need for mammography, training sessions for improved performance of the clinical breast examination, and adoption of a prompting system to remind physicians to perform BCS will be introduced. UNC radiologists will work with local radiologists to establish ongoing quality assurance systems for mammography. Radiologists and local medical leaders will work to make high quality mammography available at lower charges. Finally, a Community Invention will increase women's awareness and use of BCS with a mass media compaign. In addition, a patient-prompting program using written material (pamphlets, posters, and cards) will remind patients to ask their physicians about BCS. Each of the interventions will be developed in a modular fashion so that if useful, it can be used in other communities around the country. Evaluation will include pre- and post-test measurements in New Hanover Country and a control community, Pitt County: 1) A telephone survey of women ages 50 to 74 to determine the percentage who have received BCS in the previous year; 2) A telephone survey of physicians, to determine knowledge/attitudes towards BCS; 3) Assessment of breast lump detection competency of physicians, using manufactured silicone breast models; 4) Review of medical records to determine frequency of BCS in physicians' practices; 5) Documentation of the number and cost of mammograms performed and the existence/extent of quality assurance for mammography in radiology units; and 6) Review of local hospital pathology reports to document the pathological stage of all newly diagnosed breast cancers.