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A community-based breast cancer screening program for medically underserved women: its effect on disease stage at diagnosis and on hazard of death / Programa basado en la comunidad de tamizaje de cáncer de mama en mujeres médicamente subatendidas: efecto sobre el estadio de la enfermedad en el momento del diagnóstico y el riesgo de muerte
McCoy, Clyde B; Pereyra, Margaret; Metsch, Lisa R; Collado-Mesa, Fernando; Messiah, Sarah E; Sears, Sandy.
Afiliação
  • McCoy, Clyde B; University of Miami School of Medicine. Department of Epidemiology and Public Health. Miami. US
  • Pereyra, Margaret; University of Miami School of Medicine. Department of Epidemiology and Public Health. Miami. US
  • Metsch, Lisa R; University of Miami School of Medicine. Department of Epidemiology and Public Health. Miami. US
  • Collado-Mesa, Fernando; University of Miami School of Medicine. Department of Epidemiology and Public Health. Miami. US
  • Messiah, Sarah E; University of Miami School of Medicine. Department of Epidemiology and Public Health. Miami. US
  • Sears, Sandy; Jackson Memorial Hospital. Ambulatory Services Division. Miami. US
Rev. panam. salud pública ; 15(3): 160-167, Mar. 2004. tab, graf
Article em En | LILACS | ID: lil-363961
Biblioteca responsável: BR1.1
RESUMEN

OBJETIVO:

En estudios previos de este colectivo de investigadores se encontró que las mujeres pertenecientes a las minorías subatendidas desde el punto de vista médico en la zona del Condado de Miami-Dade, en el estado de la Florida, Estados Unidos de América, necesitaban someterse a un tamizaje para la detección de cáncer de mama y que la disponibilidad, accesibilidad y aceptación de estos servicios planteaban dificultades. En respuesta a ello se elaboró un programa comunitario integral para el tamizaje del cáncer de mama, denominado Programa de Detección Temprana (PDT). El propósito específico de este estudio fue evaluar el efecto que tuvo la participación en el PDT sobre el estadio de la enfermedad en el momento del diagnóstico y sobre el riesgo de muerte.

MÉTODOS:

Los datos existentes en el Sistema de Datos sobre Cáncer de la Florida ùun registro de cáncer que abarca a todo el estadoù se enlazaron con los datos del PDT. En diciembre de 1998 se conformó una cohorte retrospectiva multiétnica (mujeres afroestadounidenses, hispanas negras, hispanas blancas y blancas no hispanas) según los siguientes criterios de inclusión mujeres de 40 años de edad o más con cáncer de mama diagnosticado y estadificado en el Jackson Memorial Medical Center (hospital escuela de la Universidad de Miami situado en la ciudad de Miami, Florida) entre enero de 1987 y diciembre de 1997. Las participantes del PDT eran mujeres con necesidades médicas subatendidas, es decir, residían en zonas con malas condiciones socioeconómicas, no tenían un seguro de salud que cubriera los gastos médicos, o tenían un seguro limitado. Se compararon las participantes en el PDT con las mujeres que no participaron en el PDT en cuanto al estadio de la enfermedad en el momento del diagnóstico y el riesgo de muerte. Para el análisis se emplearon modelos de regresión logística y de Cox.

RESULTADOS:

Las participantes del PDT tuvieron 2,4 veces más posibilidades de tener un cáncer localizado en el momento del diagnóstico que las mujeres que no participaban (intervalo de confianza de 95% 1,71...
ABSTRACT
Objective. Earlier studies by this research team found that medically underserved minority women in the Miami-Dade County area of the state of Florida, United States, were in need of breast cancer screening and that there were problems with availability, accessibility, and acceptability of services. In response, a community-based comprehensive breast cancer screening program called the Early Detection Program (EDP) was developed. The specific purpose of this study was to assess the effect that EDP participation had on stage at diagnosis and on hazard of death. Methods. Existing data from the Florida Cancer Data System (FCDS), a statewide cancer registry, were linked with data from the EDP. In December 1998 we assembled a multiethnic (African-American, black Hispanic, white Hispanic, and white non-Hispanic) retrospective cohort with the following inclusion criteria all women aged 40 and older with breast cancer Center (which is located in the city of Miami, Florida) from January 1987 through December 1997. EDP participants were medically underserved, that is, they resided in lower socioeconomic areas and/or had limited or no health insurance to cover medical costs. Subjects identified as EDP participants were compared to nonparticipants with respect to disease stage at diagnosis and hazard of death. Logistic regression and Cox regression models were used for analysis. Results. EDP participants were 2.4 times as likely (95% confidence interval = 1.71 to 3.43) to present with a diagnosis of localized cancer as were nonparticipants, even after controlling for race and age at diagnosis. EDP participation was independently associated with both earlier diagnosis and reduced hazard of death. Conclusions. Participation in the EDP increases the likelihood of early detection of breast cancer and reduces the hazard of death for medically underserved women in the Miami-Dade County area of Florida. Interestingly, white Hispanics showed a better survival than did both African-Americans and white non-Hispanics. Our research also demonstrates the value of utilizing existing cancer registry data to evaluate a community-based program such as the EDP.
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Texto completo: 1 Coleções: 01-internacional Base de dados: LILACS Assunto principal: Neoplasias da Mama / Programas de Rastreamento Tipo de estudo: Diagnostic_studies / Etiology_studies / Incidence_studies / Observational_studies / Prognostic_studies / Risk_factors_studies / Screening_studies Limite: Adult / Aged / Aged80 / Female / Humans Idioma: En Revista: Rev. panam. salud pública Assunto da revista: SAUDE PUBLICA Ano de publicação: 2004 Tipo de documento: Article País de afiliação: Estados Unidos País de publicação: Estados Unidos
Texto completo: 1 Coleções: 01-internacional Base de dados: LILACS Assunto principal: Neoplasias da Mama / Programas de Rastreamento Tipo de estudo: Diagnostic_studies / Etiology_studies / Incidence_studies / Observational_studies / Prognostic_studies / Risk_factors_studies / Screening_studies Limite: Adult / Aged / Aged80 / Female / Humans Idioma: En Revista: Rev. panam. salud pública Assunto da revista: SAUDE PUBLICA Ano de publicação: 2004 Tipo de documento: Article País de afiliação: Estados Unidos País de publicação: Estados Unidos