Health care utilization, lifestyle, and emotional factors and mammography practices in the Childhood Cancer Survivor Study
A partir des données de la cohorte "Childhood Cancer Survivor Study" incluant 625 patientes ayant survécu à un cancer de l'enfance traité par radiothérapie thoracique, cette étude analyse leur recours à des mammographies de dépistage en fonction de leur mode de vie
Background: Women with a history of chest radiotherapy (RT) have an increased risk of breast cancer however many do not undergo annual recommended screening mammography. We sought to characterize the relationship between mammography and potentially modifiable factors, with the goal of identifying targets for intervention to improve utilization. Methods: Of 625 female participants sampled from the Childhood Cancer Survivor Study who were treated with chest RT, 551 responded to a survey about breast cancer screening practices. We used multivariate Poisson regression to assess several lifestyle and emotional factors, health care practices, and perceived breast cancer risk, in relation to reporting a screening mammogram within the last two years. Results: Women who had a Papanicolaou test (Prevalence Ratio [PR]: 1.77, 95% confidence interval [CI]; 1.26-2.49), and who perceived their breast cancer risk as higher than the average woman were more likely to have had a mammogram (PR: 1.26, 95% CI: 1.09-1.46). We detected an attenuated effect of echocardiogram screening (PR: 0.70 (0.52-0.95) on having a mammogram among older women compared to younger women. Smoking, obesity, physical activity, coping, and symptoms of anxiety, depression and somatization were not associated with mammographic screening. Conclusion: Our findings suggest that compliance with routine and risk-based screening can be an important indicator of mammography in childhood cancer survivors. Additionally, there is a need to ensure women understand their increased breast cancer risk, as a means to encouraging them to follow breast surveillance guidelines. Impact: Screening encounters could be used to promote mammography compliance in this population.