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Nationwide cross-sectional adherence to mammography screening guidelines: national behavioral risk factor surveillance system survey results

  • Epidemiology
  • Published:
Breast Cancer Research and Treatment Aims and scope Submit manuscript

Abstract

Purpose

Varying recommendations about breast cancer screening have generated much confusion about when and how often to undergo mammography screening, yet there is limited population-based data about the extent to which patients adhere to various mammographic screening guidelines in practice. Our purpose was to evaluate population-based adherence to mammographic screening using criteria from major guideline-producing organizations.

Methods

Women aged 40–74 in the 2014 Behavioral Risk Factor Surveillance System survey were included. Self-reported mammographic screening within 1 or 2 years, according to major guideline-producing organizations (American Cancer Society [ACS], US Preventative Services Task Force [USPSTF], American College of Radiology [ACR], American College of Obstetricians and Gynecologists [ACOG]) was calculated with logistic regression, adjusting for demographics and indices of access to health care.

Results

159,123 women were included. By age category, cross-sectional adherence to USPSTF guidelines ranged from 76 to 81%, ACS (55–81%) and ACR/ACOG (45–64%) with increasing age being associated improved adherence. The highest proportions of women undergoing mammographic screening were seen in women ages 65–69 (66% within last year, 81% within last 2 years). Statistically significant predictors of adherence to mammography screening included increased income category (OR 1.08, 1.07–1.09), higher education category (OR 1.13, 1.11–1.16), and increased access to health care (OR 2.25, 1.94–2.60), adjusted for age categories.

Conclusions

Adherence to mammography screening was closest to USPSTF guidelines with 76–81% cross-sectional adherence. Frequency of screening increases with age with highest screening proportions in women ages 65–69 (66% within last year, 81% within last 2 years). For all screening guidelines, adherence to mammography screening remains poor in women with limited access to health insurance with less than half of women obtaining recommended screening.

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Funding

No funding was obtained for any phase of this study.

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Authors and Affiliations

  1. Memorial Sloan Kettering Cancer Center, 1275 York Avenue, New York, NY, 10065, USA

    Anand Narayan & Elizabeth Morris

  2. Johns Hopkins School of Medicine, 733 N. Broadway, Baltimore, MD, 21205, USA

    Alexander Fischer

  3. Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe St., Baltimore, MD, 21205, USA

    Zihe Zhang

  4. Johns Hopkins Department of Radiology, 601 N. Caroline St., Baltimore, MD, 21231, USA

    Ryan Woods & Susan Harvey

Authors
  1. Anand Narayan
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  2. Alexander Fischer
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  3. Zihe Zhang
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  4. Ryan Woods
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  5. Elizabeth Morris
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  6. Susan Harvey
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Corresponding author

Correspondence to Anand Narayan.

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Conflict of interest

Study authors report no potential conflicts of interest, including relevant financial interests, activities, relationships, and affiliations. The study had not been presented previously.

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Narayan, A., Fischer, A., Zhang, Z. et al. Nationwide cross-sectional adherence to mammography screening guidelines: national behavioral risk factor surveillance system survey results. Breast Cancer Res Treat 164, 719–725 (2017). https://doi.org/10.1007/s10549-017-4286-5

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  • DOI: https://doi.org/10.1007/s10549-017-4286-5

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