Breat cancer risk and provider recommendation for mammography among recently unscreened women in the United States
Open Access
- 1 April 2006
- journal article
- Published by Springer Science and Business Media LLC in Journal of General Internal Medicine
- Vol. 21 (4), 285-291
- https://doi.org/10.1111/j.1525-1497.2006.00348.x
Abstract
BACKGROUND AND OBJECTIVE: Many women with increased breast cancer risk have not been screened recently. Provider recommendation for mammography is an important reason many women undergo screening. We examined the association between breast cancer risk and reported provider recommendation for mammography in recently unscreened women. DESIGN: Cross-sectional study using 2000 National Health Interview Survey. PARTICIPANTS: In all, 1673 women ages 40 to 75 years without cancer who saw a health care provider in the prior year and had no mammogram within 2 years. MEASUREMENTS AND ANALYSIS: We assessed breast cancer risk by Gail score and risk factors. We used multivariable logistic regression models in SUDAAN adjusted for age, race and illness burden, to examine the association between risk and reported recommendation for mammography within 1 year for all women and women ages 50 to 75 years. RESULTS: Of 1673 recently unscreened women, 29% reported a recommendation. Twelve percent of women had increased Gail risk and of these recently unscreened, high-risk women, 25% reported a recommendation. After adjustment, high-risk women were not more likely to report a recommendation than average-risk women. Results were similar for women 50 to 75 years old. No individual breast cancer factors other than age were associated with reporting a recommendation. CONCLUSIONS: Approximately 70% of recently unscreened women seen by a health care provider in the prior year reported no recommendation for mammography, regardless of breast cancer risk. This did not include women who received a recommendation and were screened. Increasing reported recommendation rates may represent an opportunity to increase screening participation among recently unscreened women, particularly for women with increased breast cancer risk.Keywords
This publication has 40 references indexed in Scilit:
- Factors associated with colon cancer screening: the role of patient factors and physician counselingPreventive Medicine, 2005
- Physician Recommendation for Papanicolaou Testing Among U.S. Women, 2000Cancer Epidemiology, Biomarkers & Prevention, 2005
- Breast carcinoma screening and risk perception among women at increased risk for breast carcinomaCancer, 2004
- ACOG Committee on Gynecologic Practice Number 292, November 2003: Primary and Preventive Care: Periodic AssessmentsObstetrics & Gynecology, 2003
- Screening for Breast Cancer: Recommendations and RationaleAnnals of Internal Medicine, 2002
- A Systems Model of Clinical Preventive Care: The Case of Breast Cancer Screening among Older WomenPreventive Medicine, 2000
- Tailored Risk Notification for Women with a Family History of Breast CancerPreventive Medicine, 1999
- GPs' management of women seeking help for familial breast cancerFamily Practice, 1999
- Interval Adherence to Mammography Screening GuidelinesMedical Care, 1991
- Projecting Individualized Probabilities of Developing Breast Cancer for White Females Who Are Being Examined AnnuallyJNCI Journal of the National Cancer Institute, 1989