Mammography rates for 20 community-based family practices in Ontario: a full practice audit

Many Canadian women 50 to 69 years of age do not have a mammogram within the recommended screening interval of every two years. Recent data suggest that over 50% of Canadian women did not have a time-appropriate mammogram and that not having a family physician was a significant factor associated with suboptimal screening. This study reviewed medical charts of 20 family physicians' practices to examine their mammography screening patterns.

Medical charts of all women between 52 and 71 years of age in 20 family practices were examined for mammography reports between September 2003 and June 2004.

Across the 20 practices, 3,430 charts of eligible women 52 to 71 years of age were reviewed (mean per practice = 173 women; ranging from 38 to 385). The two-year time-appropriate mammography rate was 58.8%. The screening rates ranged from 25% to 76% across 20 practices. Four practices attained a 70% or greater time-appropriate screening rate. When we extended the time-appropriate frame to 36 months, the overall mammography rate increased to 70.0%. Practice size, method of remuneration for patient care, use of an electronic medical record, gender or age of physician, practice setting, use of Ontario Breast Screening Program (OBSP) were not found to be significantly associated with mammography screening rates.

Mammography rates within the recommended two-year interval for women who have a regular family physician are suboptimal. The rates for women in this study, all of whom have a family physician, were only slightly higher than those reported elsewhere for women without one. Further studies are required to uncover and overcome barriers to optimal mammography screening rates.