【乳腺癌筛查:家庭医学干预有效吗?】

L'union medicale du Canada Pub Date : 1994-03-01
M D Beaulieu, D Roy, F Béland, M Falardeau, G Hébert
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摘要

在两个家庭医学中心进行了一项非随机对照试验。研究的目的是评估家庭医生对年龄在50至69岁之间、多数属于弱势社会经济群体的妇女进行乳房x光筛查的系统处方,是否允许至少60%的妇女接受筛查,并探讨哪些因素与依从处方有关。实验干预包括由家庭医生开具处方,对符合筛查条件的患者进行乳房x光检查,而不考虑遇到的原因。在研究期间,870名咨询过医生的女性中,有468人有资格接受乳房x光检查。在实验组中,符合条件的女性乳房x光检查处方率为89%。在研究结束时,实验组中58.8% (95% Conf. Int.:51.9%-65.7%)的女性通过了乳房x光检查,对照组中13.4% (95% Conf. Int.:9.4%-17.4%)的女性通过了乳房x光检查(p < 0.0001)。家庭医生干预的校正优势比为14.98(95%比值:7.86-28.58)。60岁以上的女性和那些认为自己更容易患乳腺癌的女性更有可能积极响应医生的建议。这项研究证实,在临床预防领域,家庭医生可以有效地接触到那些可能无法接触到的个体。
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[Breast cancer screening: is family medicine intervention effective?].

A non-randomized controlled trial was conducted in two family medicine centers. The objectives were to evaluate whether or not a systematic prescription by family physicians of a screening mammography to women aged 50 to 69 belonging in majority to a disadvantaged socio-economic group, would permit to reach at least 60% of them and to explore which factors were associated with compliance to the prescription. The experimental intervention consisted in the prescription by the family physician of a mammogram to those patients found eligible for the screening procedure irrespective of the reason for encounter. A total of 468 of the 870 women who consulted a physician during the study period were eligible for a screening mammography. In the experimental group, the mammography prescription rate was 89% for eligible women. At the end of the study, 58.8% (95% Conf. Int.:51.9%-65.7%) of the women in the experimental group and 13.4% (95% Conf. Int.:9.4%-17.4%) of those in the control group had passed a mammography (p < 0.0001). The adjusted odds ratio for the family physician's intervention was 14.98 (95% Conf. Int.:7.86-28.58). Women over 60 years of age and those who perceived themself more vulnerable to breast cancer were more likely to respond positively to their physician's recommendation. This study confirms that family physicians can effectively reach, in the area of clinical prevention, individuals who might not be reached otherwise.

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