乳癌篩檢陽性結果與其相關因素分析-以中部某區域醫院為例

背景「惡性腫瘤」也就是所謂的「癌症」，已連續32年蟬聯國人十大死因之首，而乳癌更為台灣地區女性死亡率第四名、發生率第一名的癌症，為避免國人錯失早期診斷及治療的機會，政府提供免費乳癌篩檢。本研究即為瞭解我國婦女乳房攝影篩檢結果與相關影響因素。目的本研究之目的在於瞭解婦女接受乳房攝影檢查的現況以及接受乳癌篩檢婦女各項影響因素與篩檢陽性結果、偽陽性結果與乳癌結果之關聯性，進而做為醫療院所擬定預防保健實施對策時之參考依據。材料與方法本研究利用衛生福利部國民健康署回饋醫療院所執行之乳癌篩檢申報資料分析，以中部某醫院自2010年7月至2014年6月共四年期間篩檢資料為樣本，資料顯示共有14,002人次接受篩檢；將資料加以彙整並以統計軟體SPSS進行分析。以描述性統計說明篩檢現況，以羅吉斯迴歸探討因素與篩檢結果之相關性。結果根據多元羅吉斯迴歸結果，在控制其他變項的影響後，篩檢陽性率在已停經者較未停經者低0.824倍、生育次數兩次較未生育者低0.647倍、生育次數三次以上較未生育者低0.568倍、曾做過乳房自我檢查者較無者高1.493倍、個人有乳癌病史者較無者高1.485倍、乳癌家族史者較無者高1.347倍、乳房密度為Mildly dense者及Extremely dense者分別較Fatty breast者高1.537倍及1.494倍，以上均達統計顯著水準。控制其他變項的影響後，在偽陽性率剩個人有癌症病史者較無者分別低0.231倍、乳攝結果需確診者較需複檢者低0.137倍。而在確診乳癌率中，僅個人有癌症病史者較無者高4.620倍。結論本研究中呈現「是否停經」、「生育次數」、「曾作過乳房自我檢查」、「個人有無癌症病史」、「個人有無乳癌家族史」及「乳房密度」等六項影響因素對乳癌篩檢陽性結果呈現顯著相關；於乳癌篩檢偽陽性結果呈現顯著相關因子為「乳攝結果需確診或需複檢」及與確診乳癌皆呈現顯著相關因子為「個人有無乳癌家族史」，衛生政策決策者應針對此些特性族群提供有效的資訊，制訂推廣篩檢之相關政策，俾利提升婦女乳癌篩檢之成效。

關鍵字

乳癌篩檢；乳房攝影篩檢；陽性率；成效評估

並列摘要

"Malignant tumor" is also being called "cancer", has been the first of the top ten of death causes in the past 3 decades. Breast cancer is the fourth death rate and the first incidence rate of the women cancer in Taiwan. In order to improve early diagnosis and survival rate, government provides free screening for breast cancer. The purpose of this study is to understand the status of women receiving breast mammography and the associations between personal characteristics and positive findings, false positive results and confirmed breast cancer cases. The results will be suggestions for healthcare setting to develop preventive healthcare policies. This study retrieved data from breast cancer screening data in Health Promotion Administration, MOHW that reported by a hospital in central Taiwan from July 2010 to June 2014. SPSS were used to analyze the descriptive statistics and logistic regression. After controlling other variances, logistic regression model showed that "menopause", "number of births", " breast self-examination", "history of cancer ", "family history of breast cancer" and "breast density" were significant associated with positive findings. "History of cancer “and "breast test results need to be re-examination or need to be confirmed" were significant associated with false positive results and only "history of cancer” was significant associated with confirmed breast cancer cases. For promoting receiving rate and effectiveness of women's breast cancer screening, policymakers should consider that effective information on these groups.