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Identify factors for insufficient (> 2 yr) mammogram screening among Oregonian women

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Cancer Causes & Control Aims and scope Submit manuscript

Abstract

Purpose

Women with breast cancer diagnosed from mammogram screenings have a lower mortality risk than women diagnosed from symptoms. Currently, the U.S Preventive Services Task Force recommends biannual screening for women aged 50–74 years old. In this study, we aimed to identify factors associated with inadequate screening defined as “no mammogram screening within past 2 years” to guide cancer prevention and early detection efforts.

Methods

This study utilized area-based probabilistic sampling survey data, collected across Oregon in 2019. Dataset weights were calculated using a raking approach. Demographic and behavior information were collected with existing validated questionnaire items from national surveys. Weighted multivariable logistic regression analyses with missing-value imputations were conducted to identify factors associated with inadequate mammogram screening.

Results

The study included 254 women 50–74 years old without previous breast or ovarian cancer history. 19.29% of the sample reported no mammogram within two years, including 1.57% with no previous mammograms. Following unadjusted analyses, the significant factors included education, occupation status, health insurance and smoking and were therefore included into the adjusted model. In the multivariate adjusted model education remained significant while occupation status, health insurance and smoking were no longer significant. Compared to women with a college graduate degree, women with less than college graduate degree were at higher risk of inadequate screening [OR (95% CI) = 3.23 (1.54, 6.74)].

Conclusions

Lack of education was significantly associated with inadequate mammogram screening even after adjusting for occupation status, health insurance and smoking, which should prompt further outreach and education.

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Data availability

The dataset analyzed and code used are available from the corresponding author on reasonable request.

Abbreviations

ACR:

American College of Radiology

ACS:

American Cancer Society

USPSTF:

United States Preventive Service Task Force

BMI:

Body Mass Index

BRFSS:

Behavioral Risk Factor Surveillance System

CDC:

Center for Disease Control

95% CI:

95% Confidence Interval

NCI:

National Cancer Institute

NHIS:

National Health Interview Survey

OHSU:

Oregon Health & Science University

OR:

Odds Ratio

U-Can Oregon:

Understanding Cancer in Oregon

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Acknowledgments

We thank ICF International for providing statistical support and the Marketing Survey Group for providing our probabilistic sample and consulting on the sampling design. We also thank Dr. Motomi Mori for providing statistical support.

Funding

Research reported in this publication was supported by the National Cancer Institute of the National Institutes of Health under Award Number P30CA069533 (B. Druker), its supplemental Population Health P30 (B. Druker/J. Shannon) and the Office of Research on Women’s Health and the National Institute of Child Health and Human Development K12HD043488 (Building Interdisciplinary Research Careers in Women’s Health, BIRCWH) (Z. Zhang). The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.

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Authors and Affiliations

  1. Division of Oncological Sciences, Knight Cancer Institute, Oregon Health & Science University, 3181 SW Sam Jackson Park Road, Portland, OR, 97239, USA

    Zhenzhen Zhang

  2. Cancer Early Detection Advanced Research, Knight Cancer Institute, Oregon Health & Science University, 3181 SW Sam Jackson Park Road, Portland, OR, 97239, USA

    Grace Curran

  3. Department of Psychology, Tulane University, 6400 Freret St., 2007 Percival Stern Hall, New Orleans, LA, 70118, USA

    Kenneth Xu

  4. Biostatistics Shared Resources, Knight Cancer Institute, Oregon Health & Science University, Portland, OR, 97239, USA

    Jeong Youn Lim

  5. OHSU-PSU School of Public Health, 3181 SW Sam Jackson Park Road, Portland, OR, 97239, USA

    Paige E. Farris & Jackilen Shannon

Authors
  1. Zhenzhen Zhang
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Contributions

ZZ was the primary investigator of the current analysis study; she conducted the primary analyses. JYL reviewed and revised the analyses. ZZ, GC, KX together wrote the first draft of the manuscript. JS, PEF, and ZZ obtained funding and performed administrative, technical, or material support of the original parental study. All authors have interpreted the results and critically revised the manuscript for valuable intellectual content.

Corresponding author

Correspondence to Zhenzhen Zhang.

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Zhang, Z., Curran, G., Xu, K. et al. Identify factors for insufficient (> 2 yr) mammogram screening among Oregonian women. Cancer Causes Control 33, 293–301 (2022). https://doi.org/10.1007/s10552-021-01529-8

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  • DOI: https://doi.org/10.1007/s10552-021-01529-8

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