上中西部地区COVID-19期间乳房x光检查的种族和民族差异

IF 4 3区医学 Q1 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

Journal of the American College of Radiology Pub Date : 2025-03-01 DOI:10.1016/j.jacr.2025.01.001

Nia Foster BS , Arissa Milton BS , Ryan W. Woods MD, MPH , Mai Elezaby MD , Joan Neuner MD, MPH , Kelly Hackett MPH , Noelle LoConte MD, MS , Elizabeth S. Burnside MD, MHS, MS , Anand K. Narayan MD, PhD

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引用次数: 0

摘要

在COVID-19之前进行的研究表明，随着时间的推移，乳房x光检查中的种族和民族差异已经减少。COVID-19对种族和少数民族人口造成了毁灭性影响，导致预防性筛查的延误。我们的目的是确定在COVID-19大流行期间，种族和少数民族群体是否不太可能接受乳房x光检查。方法采用回顾性横断面研究方法，在中西部北部的一个多站点学术医疗中心评估COVID-19大流行期间的筛查差异。参与者包括50至74岁的女性个体（2021年6月至2022年5月）。另外纳入对照组进行2019年6月至2019年5月的covid -19前病例对照比较。未经调整和调整的逻辑回归分析估计了筛查与种族和民族之间的关联，包括相互作用项，以评估与COVID-19相关的时间相互作用。研究被认为不受机构审查委员会的审查。结果共纳入37509例符合条件的女性患者。其中，73.8%的符合条件的患者在最近2年内接受过乳房x光检查（白人74.7%，黑人57.6%，亚裔67.0%，美洲印第安人60.1%，西班牙裔64.2%）。在我们的调整分析中，Black (P <；.001)，亚洲（P = .003）和美洲印第安患者（P = .001）接受筛查的可能性较小。西班牙裔患者接受筛查的可能性相当（P = .338）。非英语语言、没有保险或医疗补助、生活在农村地区与筛查减少有关(P <；措施)。总共有36768名符合条件的女性患者被纳入covid -19前的比较。与COVID-19前的时间段相比，COVID-19与筛查差异增加有关(P <；.001)，黑人和西班牙裔女性(P <；措施)。结论COVID-19大流行与种族和民族筛查差异增加有关。需要开展有针对性的外联工作，以确保医疗服务不足的患者群体公平获得乳房x光检查。

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Racial and Ethnic Disparities in Screening Mammography During COVID-19 in the Upper Midwest

Objective

Studies conducted prior to COVID-19 suggested that racial and ethnic disparities in mammographic screening have reduced over time. COVID-19 has had devastating effects on racial and ethnic minority populations, resulting in delays in preventive screening. Our purpose was to determine if racial and ethnic minority groups were less likely to receive mammographic screening during the COVID-19 pandemic.

Methods

Retrospective cross-sectional study was conducted in a multisite academic medical center in the Upper Midwest to evaluate screening disparities during the COVID-19 pandemic. Participants included 50- to 74-year-old female individuals (June 2021 to May 2022). Additional control group was included for pre-COVID-19 case-control comparison (June 2018 to May 2019). Unadjusted and adjusted logistic regression analyses estimated the association between screening and race and ethnicity including interaction terms to assess temporal interactions associated with COVID-19. Study was deemed exempt from institutional review board review.

Results

In all, 37,509 eligible female patients were included. Of them, 73.8% of eligible patients received a mammogram within the last 2 years (White 74.7%, Black 57.6%, Asian 67.0%, American Indian 60.1%, Hispanic 64.2%). In our adjusted analyses, Black (P < .001), Asian (P = .003), and American Indian patients (P = .001) were less likely to receive screening. Hispanic patients were comparably likely to receive screening (P = .338). Non-English-preferred languages, uninsured or Medicaid, and living in rural areas were associated with decreased screening (P < .001). In all, 36,768 eligible female patients were included for pre-COVID-19 comparison. Compared with the pre–COVID-19 time period, COVID-19 was associated with increased screening disparities (P < .001) for Black and Hispanic women (P < .001).

Conclusion

The COVID-19 pandemic was associated with increased racial and ethnic screening disparities. Targeted outreach efforts are required to ensure equitable access to mammographic screening for medically underserved patient populations.

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来源期刊

Journal of the American College of Radiology RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING-

CiteScore

6.30

自引率

8.90%

发文量

312

审稿时长

34 days

期刊介绍： The official journal of the American College of Radiology, JACR informs its readers of timely, pertinent, and important topics affecting the practice of diagnostic radiologists, interventional radiologists, medical physicists, and radiation oncologists. In so doing, JACR improves their practices and helps optimize their role in the health care system. By providing a forum for informative, well-written articles on health policy, clinical practice, practice management, data science, and education, JACR engages readers in a dialogue that ultimately benefits patient care.