婦女乳房X光癌症篩檢陽性發生率與篩檢行為之影響因素

Factors influencing positive occurrence rate and screening behavior of breast cancer in women

林子琪(ZI-CHI LIN)

指導教授 ： 蔡雅芳

中山醫學大學/健康管理學院/國際健康產業經營管理碩士在職專班/碩士(2022年)

https://doi.org/10.6834/csmu202200233

摘要

研究背景:乳癌是全球第二大常見癌症，在我國的發生率位於第一位之癌症。衛生福利部開始推廣乳癌的預防保健，乳房X光攝影檢查已推動多年，但仍有許多婦女未接受乳房X光攝影篩檢，有必要了解哪些因素會影響婦女接受乳房X光攝影篩檢的行為。
研究目的: 本研究探討婦女乳房X光攝影篩檢結果呈現陽性發生率與篩檢行為之影響因素，及接受篩檢行為與乳房X光攝影篩檢結果呈現陽性之間的相關性，以提供衛生機構與醫療機構未來在制定乳癌篩檢政策之參考。
研究方法:本研究採取回溯性研究，以中部某地區教學醫院，接受乳房X光攝影檢查的婦女為研究對象，從國民健康署資料庫中擷取該醫院的資料，並回溯111年1月至111年3月，共2000人個案作為本研究之次級資料來源。研究資料以SPSS 18.0統計軟體來進行分析，分析受檢婦女之個人背景、乳癌危險因子與乳房X光攝影篩檢結果呈現陽性與接受篩檢行為之影響因素，及接受篩檢行為與乳房X光攝影篩檢結果呈現陽性之間的相關性，採用的統計方法為:描述性統計、卡方檢定及邏輯式迴歸。
研究結果: 在受檢婦女樣本中有接受乳癌篩檢行為機率達67.2%，探討相關影響因素中得到以下結果，年齡方面，45-54歲的受檢者會接受篩檢行為機率相較於65歲以上受檢者高於2.532倍；疾病史方面，有疾病史會接受篩檢行為機率對於無疾病史的受檢者高於1.675倍。受檢者乳房X光檢查結果陽性率達18.8%，探討乳房X光攝影篩檢結果陽性機率的相關因素中得到以下結果，年齡方面，45-54歲的相較於年齡65歲以上婦女乳房X光攝影篩檢結果呈現陽性機率是1.910倍；教育程度方面，就讀小學對於就讀研究所婦女乳房X光攝影篩檢結果呈現陽性機率高於3.746倍，就讀國中對於就讀研究所婦女乳房X光攝影篩檢結果呈現陽性機率高於1.966倍，就讀高中對於就讀研究所婦女乳房X光攝影篩檢結果呈現陽性機率高於1.889倍；疾病史方面，有疾病史對於無疾病史婦女乳房X光攝影篩檢結果呈現陽性機率高於110.027倍；家族史方面，有家族史對於無家族史婦女乳房X光攝影篩檢結果呈現陽性機率高於10.478倍。而接受篩檢行為與乳房X光攝影篩檢結果的相關分析中，雖然初步在卡方檢定呈現有達到顯著性相關(p=.028)，進一步再以邏輯式回歸探討影響乳房X光攝影篩檢結果呈現陽性的機率則無達到統計意義(p=1.086)。

關鍵字

乳房X光攝影篩檢 ； 乳癌 ； 預防保健

並列摘要

Background:Breast cancer is the second most common cancer in the world and has the highest incidence in Taiwan. Promotion of breast cancer prevention and health care knowledge by the Ministry of Health and Welfare, and Mammograms. Among these strategies, mammography screenings have been promoted for many years. However, many women have not received a mammogram. It is necessary to understand which beheavior influence the willingness and behavior of females to undergo a mammography screening.
Objective:This study aims to investigate the factors affecting the incidence of positive mammography results and females’ screening behaviors to provide references for the future development of mammography screening policies by health and medical institutions.
Methods:This study was designed as a retrospective study. Females who underwent a mammography in a teaching hospital in the central region of Taiwan were included in this study. Data from Taichung hospitals were retrieved from Health Promotion Administration. A total of 2,000 cases from January 2022 to March 2022 were used in this study. The collected data were statistically analyzed using SPSS 18.0. The demographic characteristics of the screened females, the correlation between breast cancer risk factors and mammography screening results, and the correlation between individual backgrounds and screening behavior and the correlation between screening behavior and mammography result positive were analyzed. The statistical methods used were descriptive statistics, chi-square tests, and logistic regressions.
Results: Among the females screened, the prevalence of breast screening behavior was 67.2%. By examining relevant influencing factors, the study yielded the following results: the breast screening behavior rate was 2.532 higher among females aged 45-54 compared with those aged 65 years or older and 1.675 times higher among females with a history of disease than those without the disease. The positive rate of mammography screening results was 18.8%, and the following results were obtained by exploring the related factors. Females aged 45-54 were 1.910 times more likely to have a positive mammography screening result than those aged 65 or older. Comparing educational levels, the rate of positive mammography screening results was respectively 3.746, 1.966, and 1.889 times higher for females with elementary school, middle school, and high school education relative to those who attended graduate school. In terms of the history of disease and family history, the rate of positive mammography screening results was 110.027 times higher among females with a history of disease than those without; and females with a family history have a rate of positive mammography screening results 10.478 times higher than those without a family history. In the correlation analysis between screening behavior and mammography screening results, although the chi-squared test (p=.028) revealed a significant correlation, further logistic regression investigated the correlation between screening behavior and mammography screening results and found it without statistical significance (p=1.086).

並列關鍵字

mammography screening ； breast cancer ； preventive care

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