Patient and physician characteristics affect adherence to screening mammography: A population-based cohort study

Abstract

BackgroundScreening mammograms are widely recommended biennially for women between the ages of 50 and 74. Despite the benefits of screening mammograms, full adherence to recommendations falls below 75% in most developed countries. Many studies have identified individual (obesity, smoking, socio-economic status, and co-morbid conditions) and primary-care physician parameters (physician age, gender, clinic size and cost) that influence adherence, but little data exists from large population studies regarding the interaction of these individual factors.MethodsWe performed a historical cohort study of 44,318 Israeli women age 56–74 using data captured from electronic medical records of a large Israeli health maintenance organization. Univariate analysis was used to examine the association between each factor and adherence (none, partial or full) with screening recommendations between 2008–2014. Multivariate analysis was used to examine the significance of these factors in combination, using binary and multinomial logistic regression.ResultsAmong 44,318 women, 42%, 43% and 15% were fully, partially and non-adherent to screening recommendations, respectively. Factors associated with inferior adherence identified in our population included: smoking, obesity, low body weight, low socio-economic status, depression, diabetes mellitus and infrequent physician visits, while, women with ischemic heart disease, female physicians, physicians between the ages of 40 and 60, and medium-sized clinics were associated with higher screening rates. Most factors remained significant in the multivariate analysis.ConclusionsBoth individual and primary-care physician factors contribute to adherence to mammography screening guidelines. Strategies to improve adherence and address disparities in mammography utilization will need to address these factors.

Disparities in cancer screening in people with mental illness across the world versus the general population: prevalence and comparative meta-analysis including 4 717 839 people

“…We followed an a-priori protocol registered in PROSPERO, CRD42018114781. We complied with the procedures outlined by the 2015 update of the Preferred Reporting Items for Systematic review and Meta-Analysis Protocols (PRISMA-P) (http://www.prisma-statement.org/) (20) and the Meta-analysis Of Observational Studies in Epidemiology (MOOSE) guidelines (21), performing an electronic literature search from database inception and without language restriction on May 5th, 2019, using PubMed and PsycInfo.…”

Determinants of compliance to breast cancer screening and referral in low socio-economic regions of urban India

“…[20] A study in Israel, non-smoking was strongly associated with having three or more mammograms done during the 6 year study period. [21] Whereas, no relation between smoking status and practice of BSE was seen among Turkish women. [18] In the present study women with family history of cancer had better compliance to screening, similar to the findings of the Trivandrum trial,[15] the Iranian mammography study,[17] and US trial among Chinese immigrant women.…”

Patients Are Knowledge Workers in the Clinical Information Space

“…), 18 managing medications, 55 releasing privileged information strategically, 18 self-medicating with over-the-counter medicines and self-treating, 44,56 and requesting and receiving preventative care (seeking, etc.). 57,58 No matter the level of knowledge, patients are decision makers.…”