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Mammography Utilization in Canadian Women Aged 50 to 69

Identification of Factors that Predict Initiation and Adherence

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Abstract

Objective

To identify factors that predict initiation of mammography and adherence with biennial screening among Canadian women aged 50–69 years.

Methods

Using data from a longitudinal panel of Canadian women interviewed in the National Population Health Survey (NPHS) in 1994/95 and 2 and 4 years later, we estimated the relative risks (RR) of mammography initiation and adherence according to socio-demographic, health and lifestyle characteristics.

Results

Among 505 women with no history of mammography use at baseline, 23.0% and 41.4% initiated mammography by 2 and 4 years, respectively. Urban residence (RR=2.85) was most strongly associated with initiation by 2 years; younger age (50–54) and lower education also predicted initiation by 2 years. Younger age, birthplace outside Canada, and having a recent (<2 years) blood pressure check were associated with initiation by 4 years. Among 873 women reporting a recent (<2 years) mammogram at baseline, 88.7% also reported a recent mammogram within 2 years while 73.0% reported one at both the 2- and 4-year follow-up. Being a non-smoker was the strongest predictor of maintaining adherence both at the 2- (RR=1.18) and the 4-year (RR=1.37) follow-up.

Interpretation

Previously identified underserved groups of Canadian women (e.g., those with lower educational levels or born outside of Canada) were most likely to initiate mammography. Approximately 1 in 6 women aged 50 to 69 years remained never-users during follow-up, and fewer than half reported recent mammograms at all three survey cycles, suggesting the need to reinforce regular screening participation.

Résumé

Objectif

Établir les facteurs prédictifs de la décision de subir une première mammographie et de l’adhésion à l’examen de dépistage, à tous les deux ans, chez les Canadiennes entre 50 et 69 ans.

Méthodes

À partir des données recueillies auprès d’un groupe longitudinal de Canadiennes dans le cadre de l’Enquête nationale sur la santé de la population (ENSP) de 1994–1995, puis deux et quatre ans plus tard, nous avons estimé la probabilité relative (RR) qu’une Canadienne décide de subir une première mammographie et son adhésion à cette procédure en fonction des caractéristiques socio-démographiques et des facteurs liés à la santé et au style de vie.

Résultats

En utilisant comme groupe de référence 505 femmes n’ayant jamais subi de mammographie, on constate que 23,0 % ont subi une mammographie au cours de la deuxième année et 41,4 %, de la quatrième année. On a établi un lien de corrélation très étroit entre les résidentes des zones urbaines (RR=2,85) et la décision de subir une première mammographie au cours de la deuxième année; de la même manière, l’appartenance à un groupe d’âge (de 50 à 54 ans) et un niveau de scolarité moins élevé constituaient des variables prédictives de la décision de subir une première mammographie au cours de la deuxième année. On a établi un lien de corrélation entre, d’une part, les femmes plus jeunes, nées à l’étranger et qui ont récemment (<2 ans) subi un examen de la pression artérielle et, d’autre part, la décision de subir une mammographie avant la fin de la quatrième année. En prenant comme groupe de référence 873 femmes ayant indiqué avoir dernièrement (<2 ans) subi une mammographie par rapport à l’année de référence, on constate que 88,7 % d’entre elles ont également signalé avoir subi une mammographie au cours des deux dernières années tandis que 73 % ont indiqué avoir subi un examen de suivi au cours de la deuxième et de la quatrième année. Le statut de non-fumeur représentait la première variable prédictive en importance de la décision de subir un examen de suivi au cours de la deuxième (RR=1,18) et de la quatrième année (RR=1,37).

Interprétation

Les groupes de femmes canadiennes les moins bien desservies, que l’on a déjà identifiés (p. ex., les femmes qui ont un faible niveau de scolarité et qui sont nées à l’étranger) étaient les plus susceptibles de prendre la décision de subir une mammographie. Près d’une Canadienne sur six du groupe des 50 à 69 ans n’a pas utilisé ces services durant la période de suivi et moins de la moitié d’entre elles a indiqué avoir subi des mammographies au cours des trois cycles de l’étude, suggérant ainsi la nécessité d’accroître le taux de participation à des examens de dépistage périodiques.

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Author information

Authors and Affiliations

  1. Health Canada, Centre for Chronic Disease Prevention and Control, Ottawa, ON, Canada

    Christina M. Bancej MSc & Jay Onysko MA

  2. Departments of Community Health Sciences & Medicine, Faculty of Medicine, University of Calgary, 3330 Hospital Drive N.W., Calgary, AB, T2N 4N1, Canada

    Colleen J. Maxwell PhD (Associate Professor)

  3. Departments of Community Health Sciences and Clinical Neurosciences, University of Calgary, Canada

    Michael Eliasziw PhD

Authors
  1. Christina M. Bancej MSc
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  2. Colleen J. Maxwell PhD
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  3. Jay Onysko MA
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  4. Michael Eliasziw PhD
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Correspondence to Colleen J. Maxwell PhD.

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Bancej, C.M., Maxwell, C.J., Onysko, J. et al. Mammography Utilization in Canadian Women Aged 50 to 69. Can J Public Health 96, 364–368 (2005). https://doi.org/10.1007/BF03404034

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