부산대학교 도서관

Background: Incidence and mortality rates for breast cancer have increased dramatically in the past two decades, while average onset age has fallen. Mammography is accepted as an effective screening tool for breast cancer. However, as the Taiwan National Health Insurance (NHI) only pays for mammography tests in women over 45 years of age, women under this age must pay for elective mammography examinations out-of-pocket.Purpose: This study examined factors that encouraged women under 45 years to have a mammography examination despite lack of NHI reimbursement.Methods: We used secondary data analysis in this study. We enrolled a total of 1853 subjects aged 30-44 years who participated in a Li-Shin Outreaching Neighboring Screening (LIONS) program for the first time between 2002 and 2007. Prior mammography utilization, demographic profiles and risk factors for breast cancer were analyzed. A multivariate logistic regression model was applied to estimated an adjusted the odds ratio (OR) and 95% confidence intervals (95% CI).Results: A total of 220 women with an average age of 38.5±4.2 years had elective mammography. In terms of analyzed factors, women regularly practicing breast self-examination showed a higher mammography usage rate (OR 1.96, 95% CI=1.34-2.87) and those with a prior history of breast disease were more often to use mammography (OR 2.27, 95% CI=1.61-3.20). In addition, relatively more individuals with a family history of breast cancer had regular mammography tests than those without (OR 2.34, 95% CI=1.25-4.36).Implications: Results provide the information to help further promote mammography screening in women aged 30 to 44 years. Acquired data will also help mammography insurance reimbursement policy makers to review and revise relevant healthcare strategies.