Elsevier

Preventive Medicine

Volume 27, Issue 3, May 1998, Pages 478-487
Preventive Medicine

Regular Article
Underusers of Mammogram Screening: Stage of Adoption in Five U.S. Subpopulations,☆☆,

https://doi.org/10.1006/pmed.1998.0310Get rights and content

Abstract

Background. The purpose of this report is to describe the characteristics of women ages 50 to 80 who do not follow commonly accepted mammography screening guidelines. It provides unique understanding of the robustness of characteristics of underusers across five different U.S. subpopulations.

Methods. The data are from the baseline surveys of the five studies of the NCI Breast Cancer Screening Consortium. Stage of adoption of mammography screening and other characteristics of underusers are presented. Polytomous logistic regression analysis was used to explore multivariable associations with stage of adoption in each study site.

Results. The five samples studied by the Consortium range in size from 259 to 4,477 women (n= 11,292). The relationship of the perceptions of the pros and cons of mammography with stage of adoption was strikingly similar across the five samples. Other variables consistently associated with stage were a recent receipt of a breast physical examination and recommendation for mammography by a physician.

Conclusions. The findings suggest a need to encourage regular screening through effective communication from a health care provider. Intervention messages should be designed to increase the pros of mammography, decrease the cons, and highlight these differentially according to the woman's stage of adoption.

References (36)

  • C Lerman et al.

    Factors associated with repeat adherence to breast cancer screening

    Prev Med

    (1990)
  • H Howe

    Repeat mammography among women over 50 years of age

    Am J Prev Med

    (1992)
  • BK Rimer et al.

    Screening practices among women in a community health center

    Am J Prev Med

    (1996)
  • Dawson, D, A, Thompson, G, B, Breast cancer risk factors and screening: United States, 1987, Hyattsville, MD, National...
  • N Breen et al.

    Changes in the use of Screening mammography: evidence from the 1987 and 1990 National Health Interview Surveys

    Am J Public Health

    (1994)
  • LM Anderson et al.

    Has the use of cervical, breast and colo-rectal screening increased in the United States?

    Am J Public Health

    (1995)
  • RS Hayward et al.

    Preventive care guidelines: 1991

    Ann Intern Med

    (1991)
  • C Mettlin et al.

    The American Cancer Society guidelines for the cancer related check-up: an update

    CA Cancer J Clin

    (1992)
  • Guide to clinical preventive services

    (1996)
  • M Costanza

    Breast cancer screening in older women: overview

    J Gerontol

    (1992)
  • JAMA

    (1990)
  • JG Zapka et al.

    Interval adherence to mammography screening guidelines

    Med Care

    (1991)
  • DS Lane et al.

    Trends in mammography use and their relation to physician and other factors

    Cancer Detect Prev

    (1996)
  • SA Fox et al.

    Effect of physician-patient communication on mammography utilization by different ethnic groups

    Med Care

    (1991)
  • SA Fox et al.

    The importance of physician communication on breast cancer screening of older women

    Arch Intern Med

    (1994)
  • MA Burg et al.

    Age group differences in the use of breast cancer screening tests: the effects of health care utilization and socio-economic variables

    J Aging Health

    (1989)
  • K Glanz et al.

    Factors associated with adherence to breast cancer screening among working women

    J Occup Med

    (1992)
  • Cited by (73)

    • Factors affecting uptake of cervical cancer screening among Chinese women in New Zealand

      2008, International Journal of Gynecology and Obstetrics
      Citation Excerpt :

      These findings are in line with other studies on the Chinese emigrant population [5,7]. A strong association between physicians' recommendations and women's use of cancer screening tests has been documented in diverse populations [15–17], demonstrating the importance of primary care relationships and engagement. Although age and years lived in New Zealand were found to be associated with cervical screening practice in the model that only considered sociodemographic factors [11], the effects of these two factors diminished and were no longer statistically significant after introducing other important factors.

    • Lower adherence to screening mammography guidelines among ethnic minority women in America: A meta-analytic review

      2008, Preventive Medicine
      Citation Excerpt :

      Authors of four studies responded and provided the necessary information. Fourteen studies were excluded for the following three reasons: (a) sample sizes for ethnic/racial groups were not reported (Caplan et al., 1992; Casey et al., 2001; Friedman et al., 1995; Goel et al., 2003; Lane et al., 2000; O'Malley et al., 1997; Regan et al., 1999; Stoddard et al., 1998; Yood et al., 1999); (b) data on the white non-Hispanic comparison group were not reported (Wampler et al., 2006); and (c) combined screening and diagnostic mammograms (Henderson and Schenck, 2001; Parker et al., 1998; Preston et al., 1997; Sabogal et al., 2001). The 33 studies identified compared white non-Hispanic women to African American women, Hispanic women, and Asian/Pacific Islander women.

    View all citing articles on Scopus

    The preparation of this paper was supported by the National Cancer Institute under Grants R01-CA63782, R01-CA60131, R01-CA65880, R01-CA60129, and R01-CA60130.

    ☆☆

    The NCI Breast Cancer Screening Consortium comprises the following institutions and investigators: Duke University Medical Center (Durham, NC): Barbara K. Rimer, Dr.P.H., principal investigator, Fred Hutchinson Cancer Research Center (Seattle, WA): Nicole Urban, Sc.D., principal investigator, RAND-UCLA (Los Angeles, CA): Sarah A. Fox, Ed.D., M.P.H., principal investigator; State University of New York at Stony Brook: Dorothy S. Lane, M.D., M.P.H., principal investigator, University of Massachusetts Medical Center. Mary E. Costanza, M.D., principal investigator; University of Massachusetts, School of Public Health and Health Sciences: Anne M. Stoddard, Sc.D.; NCI, Division of Cancer Prevention and Control: Helen Meissner, Sc.M.; NCI, Applied Research Branch: Nancy Breen, Ph.D. We are grateful to William Rakowski, Ph.D., for assistance in item and scale development and to Sharon Longo, M.S., for assistance with data analysis.

    Miller, WHeather, N

    2

    To whom reprint requests should be addressed. Fax: (413) 545-1645.

    View full text