Partnership Loss and Receipt of Guideline-adherent Biennial Mammography Screening

To examine the association between partnership dissolution and receipt of biennial mammography screening in a national cohort of older women. We used data from the Health and Retirement Study, a longitudinal study of older adults in the US. Our analysis used data from five waves spanning from 2004 to 2021, including women 52-76 years who were initially married/partnered. The primary outcome was receipt of mammography screening in the past two years, and the primary exposure was partnership status (partnered, divorced/separated, or widowed), assessed at the beginning of the two-year window. Fixed-effects logistic regression modeled the association between a change in partnership status and change in receipt of mammography screening. Our final sample had 5,628 respondents contributing 17,097 total observations. At their most recent wave, 76% received mammography screening, and across the study period, 3% became separated/divorced and 7% became widowed. On multivariable regression with fixed-effects specification, there was no significant change in mammography screening following separation/divorce (adjusted odds ratio [aOR]: 1.11; 95% confidence interval [CI]: 0.75, 1.64; p = 0.599), but the odds of screening decreased after becoming widowed (aOR: 0.72; 95% CI: 0.55, 0.95; p = 0.018), controlling for age and other time-varying covariates. This evidence suggests that bereaved older women may be susceptible to decreased engagement in mammography screening following the loss of a partner. Future endeavors should investigate strategies promoting re-engagement in preventive care, including breast cancer screening, among bereaved older women.