Patterns of Mammography Screening in Women with Breast Cancer in a Kansas Community.

S Lai, K Molnar, L Huang, S Garimella, M Enko, P Pordell, A White, V Senkomago
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Abstract

Purpose: The objective of this study was to examine patterns of mammography screening prior to breast cancer diagnosis in all women with breast cancer in a Kansas community.

Methods: The study population included 508 women in the Kansas Cancer Registry database diagnosed with breast cancer between 2013-2014 who were patients and residents of a defined area at the time of diagnosis. Screening history within 4 years of diagnosis was obtained. Poisson regression analysis was used to examine the relationship between sociodemographic factors and biennial screening.

Results: About 41.5% of women received at least biennial screening, while 22.1% received less than biennial screening and 36.4% had no screening. About 40% of women aged 50-64, 50.4% aged 65-74, and 48.3% aged 75-84 received biennial screening (p=0.002). Women diagnosed with in-situ and localized breast cancers had significantly higher proportions of biennial screening (46.7% and 48.6%, respectively; p < 0.001). Average tumor size was 15.7, 17.4, and 24.4 mm, for women who received at least biennial, some, and no screening, respectively (p < 0.001). Results from Poisson regression analysis showed the adjusted relative risk associated with rural/mixed residence at diagnosis and Medicaid beneficiary was 0.45 and 0.40 (p=0.003 and p=0.032) respectively.

Conclusions: Biennial mammography screening was associated with lower breast cancer stage and smaller tumor size, illustrating the importance of screening as early detection. Different outreach strategies may be necessary to reach women within varied age groups or geographical regions to help increase the number of women who remain up-to-date with mammography screening.

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堪萨斯州社区乳腺癌妇女的乳房x光检查模式
目的:本研究的目的是检查堪萨斯州社区所有乳腺癌妇女在乳腺癌诊断前的乳房x光检查模式。方法:研究人群包括2013-2014年堪萨斯州癌症登记处数据库中诊断为乳腺癌的508名妇女,她们在诊断时是特定地区的患者和居民。获得诊断后4年内的筛查史。用泊松回归分析检验社会人口学因素与两年一次筛查的关系。结果:约41.5%的女性至少接受了两年一次的筛查,22.1%的女性接受了少于两年一次的筛查,36.4%的女性没有接受筛查。50-64岁女性约40%、65-74岁女性50.4%、75-84岁女性48.3%接受了两年一次的筛查(p=0.002)。确诊为原位和局部乳腺癌的女性进行两年一次筛查的比例明显更高(分别为46.7%和48.6%);P < 0.001)。平均肿瘤大小分别为15.7、17.4和24.4 mm,分别为至少两年一次接受筛查、部分接受筛查和未接受筛查的女性(p < 0.001)。泊松回归分析结果显示,诊断时农村/混合居住地与医疗补助受益人相关的调整相对风险分别为0.45和0.40 (p=0.003和p=0.032)。结论:两年一次的乳房x线摄影筛查与较低的乳腺癌分期和较小的肿瘤大小相关,说明筛查作为早期发现的重要性。可能需要采取不同的外展策略来接触不同年龄组或地理区域的妇女,以帮助增加接受最新乳房x光检查的妇女人数。
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