研究新技术（如数字乳腺X线摄影）的时空扩散，可以提供重要的见解，了解新医疗技术获得的准入差异以及这些技术被采纳的速度。尽管数字乳腺X线摄影目前是美国的标准技术进行乳腺癌筛查，但随着医疗机构从胶片向数字单位的转变，它的采用和地理扩散还没有得到很好的研究。本研究评估了2001年至2014年间数字乳腺X线摄影设施在美国（阿拉斯加和夏威夷除外）连续的地理扩散，并估计在人口密度、城乡居住和种族/民族方面，20分钟驾车时间内人口普查区级别的妇女（年龄≥45岁）对这种新技术的地理可达性。还总结了按技术类型（胶片或数字）和每10,000名妇女的密度的乳腺X线摄影机数量。数字乳腺X线摄影的采用率首先在人口稠密地区上升，在偏远农村地区最后才采用。总体而言，2001年至2014年间数字乳腺X线摄影机的比例从1.4％增加到94.6％，但自2008年以来，单位密度从2.31/10,000名年龄≥45岁的妇女下降至2014年的1.97。在2014年，美国连续的州中约有87％的年龄≥45岁的女性可接受数字乳腺X线摄影，但对于美国原住民妇女（67％）和农村居民（32％），这一比例明显较低。了解数字乳腺X线摄影的扩散和可访问性可以帮助预测未来医疗技术的扩散，并评估它在癌症诊断和治疗地理差异中的作用。 ©2023年美国癌症协会。

Examining temporal and spatial diffusion of a new technology, such as digital mammography, can provide important insights into potential disparities associated with access to new medical technologies and how quickly these technologies are adopted. Although digital mammography is currently a standard technology in the United States for breast cancer screening, its adoption and geographic diffusion, as medical facilities transitioned from film to digital units, has not been explored well.This study evaluated the geographic diffusion of digital mammography facilities from 2001 to 2014 in the contiguous United States (excluding Alaska and Hawaii) and estimated the geographic accessibility to this new technology for women aged ≥45 years at the census tract level within a 20-minute drivetime by population density, rural/urban residence, and race/ethnicity. The number of mammography units by technology type (film or digital) and density per 10,000 women were also summarized.The adoption of digital mammography advanced first in densely populated regions and last in remote rural areas. Overall, proportion of digital mammography units increased from 1.4% in 2001 to 94.6% in 2014, but since 2008, there was a decline in density of units from 2.31 per 10,000 women aged ≥45 years to 1.97 in 2014. In 2014, approximately 87% of women aged ≥45 years in the contiguous United States had accessibility to digital mammography, but this proportion was substantially lower for Native American women (67%) and rural residents (32%).Understanding the diffusion of and accessibility to digital mammography may help predict future medical technology diffusion and assess its role in geographic differences in cancer diagnosis and treatment.© 2023 American Cancer Society.