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Factors associated with women's adherence to mammography screening guidelines
K A Phillips1, K Kerlikowske, L C Baker
1University of California-San Francisco 94105, USA.
Health Services Research
|May 5, 1998
Summary
Mammography screening adherence is low, with only 27% of women meeting guidelines. Factors like shared decision-making and accessible facilities improve adherence, highlighting the need for focused efforts.
Area of Science:
- Public Health
- Preventive Medicine
- Health Services Research
Background:
- Mammography screening is crucial for early breast cancer detection.
- Adherence to recommended mammography screening guidelines remains a public health challenge.
Purpose of the Study:
- To identify individual and environmental factors influencing adherence to mammography screening guidelines among women aged 50-74.
- To understand predictors of ever having had mammography, recent mammography, and guideline adherence.
Main Methods:
- Cross-sectional study linking national health surveys, mammography facility data, HMO market share, and primary care provider supply.
- Analysis of a weighted sample of 2,026 women aged 50-74 using logistic regression.
- Adherence defined as age-appropriate lifetime exams and recent screening (within two years).
Main Results:
- Only 27% of women met age-appropriate screening guidelines; 59% had recent screening.
- Factors associated with higher adherence included shared decision-making, younger age, higher education/income, recent Pap smear, and breast problems.
- Environmental factors like reminder systems, provider availability, HMO market share, and screening charges also influenced adherence.
Conclusions:
- A significant gap exists in adherence to mammography screening guidelines.
- Clinical, programmatic, and policy interventions are needed to improve screening adherence.