台灣中老年女性未接受乳房攝影篩檢之因子

Factors Associated with Non-Utilization of Mammographic Screening Services in Middle-Aged and Elderly Women in Taiwan

背景：乳癌在台灣女性癌症的年發生率排名首位，死亡年齡中位數僅57歲，然而民眾接受乳房攝影篩檢比例偏低。國外文獻指出乳房攝影篩檢行為與年齡、教育程度、種族及癌症病史等有關，至於台灣以代表性樣本的研究報告則較為缺乏。目的：探討台灣50至69歲女性未接受乳房攝影篩檢之相關因子。方法：本研究採用次級資料分析法，以國家衛生研究院「2005年國民健康訪問調查個人問卷」為資料來源，並參考安德遜健康服務利用行為模式為研究架構，以羅吉斯廻歸分析影響台灣女性乳房攝影篩檢行為之相關因子。結果：台灣50至69歲女性接受乳房攝影篩檢比例僅為24.3%。多變項羅吉斯迴歸分析顯示，影響台灣中老年女性未接受乳房攝影篩檢之顯著獨立因子包括：較低教育程度、有工作、每月平均收入較低、沒有購買全民健康保險外之其他商業保險、從未接受過全身性健康檢查及從未因更年期接受過荷爾蒙治療。結論／實務應用：本研究結果可提供醫院及衛生單位在策劃乳房攝影篩檢方案時之參考。在設計乳房攝影篩檢宣導內容時，考量較低教育程度對象的需求，並與職場結合方便職業女性接受乳房攝影篩檢的方案，同時針對從未接受過全身性健康檢查的女性加強宣導。藉由增強女性接受乳房攝影篩檢的意願，減少乳癌對女性生命之威脅。

Background: Breast cancer is currently the type of cancer with the highest annual incidence among women in Taiwan, resulting in a median age of death of 57 years. Nevertheless, the proportion of Taiwanese women with a history of mammographic screening is relatively low. The international literature associates participation in mammographic screening with factors such as age, education level, ethnicity, and previous cancer history. Few such studies in Taiwan have addressed a cross-section sample that is representative of the overall population.Purpose: The present study investigated factors associated with non-utilization of mammographic screening in women aged between 50 to 69 years in Taiwan.Methods: This study used secondary data analysis to investigate data obtained from the 2005 National Health Interview Survey in Taiwan. Researchers used logistic regression analysis to evaluate factors associated with mammographic screening in Taiwanese women based on the Andersen behavioral model of health services use. Results: Only 24.3% of the survey population had received mammographic screening.Results of multiple logistic regression analysis indicated non-utilization of mammographic screening is associated with a relatively low education level, being currently employed, a relatively low average monthly salary, having no additional insurance coverage outside the National Health Insurance, having no physical examination history, and having no history of menopausal hormone replacement therapy use.Conclusions: Hospitals and health units may use findings from the present study to plan mammographic screening programs. Mammography promotional material should consider the needs of women with lower education levels; screening schedules should be coordinated with employers and made convenient for working women; and promotional materials should target women who have never previously received a physical examination. Enhancing the willingness of women to obtain mammography may reduce the threat of breast cancer to the lives of Taiwanese women.