RESUMO
The public health response to cancer in the New York State Department of Health has evolved over many years. A number of organizational units contribute to surveillance and monitoring, quality assurance, policy analysis and advocacy, education, service delivery, and evaluation components. Extensive cooperation with health professionals and consumers outside of state government is also essential.
Assuntos
Promoção da Saúde/organização & administração , Neoplasias/prevenção & controle , Adolescente , Adulto , Idoso , Neoplasias da Mama/prevenção & controle , Feminino , Humanos , Pessoa de Meia-Idade , New York , Vigilância da População , Garantia da Qualidade dos Cuidados de Saúde , Tabagismo/prevenção & controle , Neoplasias do Colo do Útero/prevenção & controleRESUMO
BACKGROUND: The ability of screening mammography programs serving women of different socioeconomic status (SES) to diagnose early stage breast carcinoma in a comparably effective fashion has been questioned. METHODS: Results of screening 50,653 women of lower SES were compared with those of screening 45,923 more socioeconomically advantaged women during the same period in New York State. Results were compared with those reported for the general population to the New York State cancer registry. RESULTS: Additional workup was required for approximately 12% of the women in each group. Although more women of lower SES underwent biopsy, the positive predictive value of a biopsy recommendation was almost the same for the two populations (27% for women of higher SES vs. 25% for women of lower SES). Among women with breast carcinoma, ductal carcinoma in situ was diagnosed in 27% of more affluent women and 15% of women of lower SES, a considerable improvement from the 10% rate of diagnosis in the general population in New York State. Minimal cancers accounted for 54% of those diagnosed in more affluent women and at least 31% of those diagnosed in women of lower SES. CONCLUSIONS: Screening mammography programs can be effective for women of lower SES and can be conducted as efficiently as they are for more affluent women. Differences in diagnosis of small cancers in the two groups reported in this article may reflect differences in age and patterns of prior screening experience in the two populations.