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Use of screening mammography by general internists
V M Taylor1, D E Montano, T Koepsell
1Fred Hutchinson Cancer Research Center, Seattle.
Cancer Detection and Prevention
|January 1, 1994
Summary
Many physicians do not routinely order screening mammograms for eligible women, despite their importance. Physician beliefs and lack of reminder systems are key barriers to mammography utilization.
Area of Science:
- Medical screening
- Public health
- Preventive medicine
Background:
- Physician endorsement is crucial for women's screening mammogram uptake.
- Physicians are observed to under-refer women for mammography services.
- Understanding physician-related barriers is essential for improving screening rates.
Purpose of the Study:
- To investigate reasons why physicians underutilize screening mammography referrals.
- To identify factors associated with the routine use of mammography by general internists.
Main Methods:
- A mail survey was conducted among randomly selected Washington State general internists in 1989.
- An expanded theory of reasoned action framework guided the survey.
- The study analyzed factors influencing mammography referral practices.
Main Results:
- Only 38% of surveyed physicians always ordered mammograms for women aged 50+ during preventive visits.
- Nearly half (43%) of respondents lacked a reminder system for mammography.
- Physician-related barriers (e.g., doubts about effectiveness) impacted use more than patient barriers (e.g., cost).
Conclusions:
- A significant proportion of general internists do not routinely order mammograms for age-eligible female patients.
- Barriers to mammography use by physicians must be addressed to enhance national screening efforts.
- Professional organization recommendations positively influenced physician mammography ordering practices.