背景 : 近二十年來，乳癌的發生率及死亡率逐年攀升，罹患年齡層卻逐年下降，乳房攝影術已被證實是一有效乳癌篩檢工具，然而目前國家政策僅提供 45歲（含）以上婦女免費施作， 44歲（含）以下年輕婦女須自費接受乳房攝影檢查。 目的 : 探討 30－44歲年輕婦女執行乳房攝影篩檢之現況及其影響因素。 方法 : 本研究使用次級資料分析，分析 2002年至 2007年間，首次參與壢新醫院之世代研究（Li-Shin Outreaching Neighboring Screening, LIONS），且年齡介於 30－44歲共 1853位之女性為調查對象，過往是否接受乳房攝影檢查，與其人口學特徵、乳癌高危險因子等資料之相關性，並以多變項邏輯式迴歸估算調整後勝算比與 95%信賴區間。 結果 : 在 1,853位女性中有 220位願意自費接受乳房攝影，其平均年齡為 38.5 ± 4.2歲，在其影響執行乳房攝影之動機調查發現，定期執行乳房自我檢查者比未定期執行乳房自我檢查者多出 1.96倍（ 95% CI = 1.34－2.87）；過往有乳房疾病者較無乳房疾病者會執行乳房攝影篩檢多出 2.27倍（ 95% CI = 1.61－3.20）；而過往有家族乳癌病史者比無家族乳癌病史者執行乳房攝影篩檢則有 2.34倍（ 95% CI = 1.25－4.36）。 實務應用 : 研究結果提供政府相關機構，對於乳癌攝影篩檢之醫療保險給付政策之參考依據，並能針對年輕但處於高危險之婦女族群有更多之保險措施。

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.