Socioeconomic Disparities in Breast Cancer Screening among US Women: Trends from 2000 to 2005
2
조회
0
다운로드
2
인용
0
참고문헌
키워드
초록
Objectives : This study describes trends in the socioeconomic disparities in breast cancer screening among US women aged 40 or over, from 2000 to 2005. We assessed 1) the disparities in each socioeconomic dimension; 2) the changes in screening mammography rates over time according to income, education, and race; and 3) the sizes and trends of the disparities over time. Methods : Using data from the Behavioral Risk Factor Surveillance System (BRFSS) from 2000 to 2005, we calculated the age-adjusted screening rate according to relative household income, education level, health insurance, and race. Odds ratios and the relative inequality index (RII) were also calculated, controlling for age. Results : Women in their 40s and those with lower relative incomes were less likely to undergo screening mammography. The disparity based on relative income was greater than that based on education or race (the RII among low-income women across the survey years was 3.00 to 3.48). The overall participation rate and absolute differences among socioeconomic groups changed little or decreased slightly across the survey years. However, the degree of each socioeconomic disparity and the relative inequality among socioeconomic positions remained quite consistent. Conclusions : These findings suggest that the trend of the disparity in breast cancer screening varied by socioeconomic dimension. Continued differences in breast cancer screening rates related to income level should be considered in future efforts to decrease the disparities in breast cancer among socioeconomic groups. More focused interventions, as well as the monitoring of trends in cancer screening participation by income and education, are needed in different social settings.
Abstract
Objectives : This study describes trends in the socioeconomic disparities in breast cancer screening among US women aged 40 or over, from 2000 to 2005. We assessed 1) the disparities in each socioeconomic dimension; 2) the changes in screening mammography rates over time according to income, education, and race; and 3) the sizes and trends of the disparities over time. Methods : Using data from the Behavioral Risk Factor Surveillance System (BRFSS) from 2000 to 2005, we calculated the age-adjusted screening rate according to relative household income, education level, health insurance, and race. Odds ratios and the relative inequality index (RII) were also calculated, controlling for age. Results : Women in their 40s and those with lower relative incomes were less likely to undergo screening mammography. The disparity based on relative income was greater than that based on education or race (the RII among low-income women across the survey years was 3.00 to 3.48). The overall participation rate and absolute differences among socioeconomic groups changed little or decreased slightly across the survey years. However, the degree of each socioeconomic disparity and the relative inequality among socioeconomic positions remained quite consistent. Conclusions : These findings suggest that the trend of the disparity in breast cancer screening varied by socioeconomic dimension. Continued differences in breast cancer screening rates related to income level should be considered in future efforts to decrease the disparities in breast cancer among socioeconomic groups. More focused interventions, as well as the monitoring of trends in cancer screening participation by income and education, are needed in different social settings.
참고문헌 (37)
- "States Cancer Statistics: 1999-2004 Cancer Incidence and Mortality Data"[URL]
- "Health at a Glance 2007"[URL]
- "What Are the Key Statistics for Breast Cancer?"[URL]
- Elmore, J.G., "Screening for breast cancer", JAMA, 293(10), pp.1245~1256 (2005)
- Smigal, C., "Trends in breast cancer by race and ethnicity: Update 2006", CA Cancer J Clin, 56(3), pp.168~183 (2006)
- Feldstein, A.C., "Mammography screening rates decline: A person-time approach to evaluation", Prev Med, 43(3), pp.178~182 (2006)
- Burns, R.B., "Black women receive less mammography even with similar use of primary care", Ann Intern Med, 125(3), pp.173~182 (1996)
- Makuc, D.M., "Low income, race, and the use of mammography", Health Serv Res, 34, pp.229~239 (1999)
- Schootman, M., "Disparities related to socioeconomic status and access to medical care remain in the United States among women who never had a mammogram", Cancer Causes Control, 14(5), pp.419~425 (2003)
- Bigby, J., "Disparities across the breast cancer continuum", Cancer Causes Control, 16(1), pp.35~44 (2005)
- Peek. M.E., "Disparities in screening mammography Current status, interventions and implications", J Gen Intern Med, 19(2), pp.18 (2004), 4~194
- Farria, D.M., "Professional and economic factors affecting access to mammography: A crisis today, or tomorrow? Results from a national survey", Cancer, 104(3), pp.491~498 (2005)
- Coughlin, S.S., "Breast and cervical cancer screening practices among Asian and Pacific Islander Women in the United States, 1994-1997", Cancer Epidemiol Biomarkers Prev, 9(6), pp.597~603 (2000)
- Ward, E., "Cancer disparities by race", ethnicity and socioeconomic status, 2004, pp.54(2), 78~93
- Blustein, J., "Medicare coverage, supplemental insurance, and the use of mammography by older women", N Engl J Med, 332(17), pp.1138~1143 (1995)
- Hedegaard, H.B., "Factors associated with screening mammography in low-income women", Am J Prev Med, 12(1), pp.51~56 (1996)
- Blackman, D.K., "Trends in self-reported use of mammograms (1989-1997) and Papanicolaou tests (1991- 1997)-Behavioral Risk Factor Surveillance System", MMWR CDC Surveill Summ, 48(6), pp.1~22 (1999)
- Harper, S., "Trends in socioeconomic inequalities in adult health behaviors among U.S. states, 1990-2004", Public Health Rep, 122(2), pp.177~189 (2007)
- 신명희, "서울시 암 발생률의 10년간 추이: 1993-2002", 예방의학회지, 41(2), pp.92~99 (2008), 대한예방의학회
- "Behavioral Risk Factor Surveillance System: About the BRFSS-Overview"[URL]
- Davey Smith, G., "Education and occupational social class: which is the more important indicator of mortality risk?", J Epidemiol Community Health, 52(3), pp.153~160 (1998)
- Kunst, A.E., "The size of mortality differences associated with educational level in nine industrialized countries", Am J Public Health, 84(6), pp.932~937 (1994)
- Mackenbach, J.P., "Measuring the magnitude of socio-economic inequalities in health: An overview of available measures illustrated with two examples from Europe", Soc Sci Med, 44(6), pp.757~771 (1997)
- Sergeant, J.C., "Relative index of inequality: Definition, estimation, and inference", Biostatistics, 7(2), pp.213~224 (2006)
- Research Triangle Institute, "SUDAAN UserVs Manual, Release 9.0" (2001), Research Triangle Institute
- Shah, B.V., "SUDAAN Software for Analysis of Correlated Data, Release 9. UserVs Manual" (2004), Research Triangle Institute
- Snider, J., "Trends in mammography and Pap smear utilization in Canada", Chronic Dis Can, 17(3-4), pp.108~117 (1996)
- Katz, S.J., "Breast cancer screening in the United States and Canada, 1994: Socioeconomic gradients persist", Am J Public Health, 90(5), pp.799~803 (2000)
- 곽민선, "암 검진 수검에 영향을 주는 요인", 예방의학회지, 38(4), pp.473~481 (2005), 대한예방의학회
- 장숙랑, "자궁경부암 검진 수검률의 불평등 추이", 예방의학회지, 40(6), pp.505~511 (2007), 대한예방의학회
- Smith-Bindman, R., "Does utilization of screening mammography explain racial and ethnic differences in breast cancer?", Ann Int Med, 144(8), pp.541~553 (2006)
- Henson, R.M., "The national breast and cervical cancer early detection program: A comprehensive public health response to two major health issues for women", J Public Health Manag Pract, 2(2), pp.36~47 (1986)
- Bush, R.A., "The effects of insurance coverage and ethnicity on mammography utilization in a postmenopausal population", West J Med, 168(4), pp.236~240 (1998)
- Berry, D.A., "Effect of screening and adjuvant therapy on mortality from breast cancer", Obstet Gynecol Surv, 61(3), pp.179~180 (2006)
- Wojcik, B.E., "Effects of screening mammography on the comparative survival rates of African American, white, and Hispanic beneficiaries of a comprehensive health care system", Breast J, 9(3), pp.175~183 (2003)
- OVMalley, M.S., "The association of race", ethnicity, socioeconomic status, and physician recommendation for mammography: who gets the message about breast cancer screening?, 2001, pp.91(1), 49~54
- Hussey P., "Trends in socioeconomic disparities in health care quality in four countries", Int J Qual Health Care, 20(1), pp.53~ (2008)