Abstract 37: Understanding the social determinants of guideline-based mammography adherence across race/ethnicity: Results from the 2016 California Health Interview Survey

Abstract

Abstract Purpose: There is not a consensus concerning recommendations about breast cancer screening which has generated confusion about when and how often to undergo mammography screening in the population, 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 across race/ethnicity to understand what social determinants of mammography adherence are associated with each guideline producing institution. Methods: Women aged 45-79 in the 2016 California Health Interview 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, health care, insurance status, and BMI. Results: 7,551 women were included in this study. By age category, cross-sectional adherence to ACR/ACOG (annual screening) (65 to 67%) and USPSTF guidelines (biennial screening) ranged from 82-83% and with increasing age being generally associated higher adherence. The highest proportions of women undergoing mammographic screening were seen in women ages 60-69 (67% within last year, 85% within last 2 years). Statistically significant predictors of adherence to mammography screening included Latina race (OR 1.62, 0.18 SE), full time employment (OR 0.73, 0.09 SE), and not having a usual healthcare provider (OR 0.50, 0.12 SE), adjusted for demographics, health care, insurance status, and BMI. Conclusion: 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 ACR/ACOG screening guidelines, adherence to mammography screening remains poorer in women with no usual source of care, given that their odds of exhibiting adherence was half that of women who did have a regular source of care and nearly 65 percent lower odds of those women with USPSTF mammography adherence. Key Words: Breast cancer, screening, race/ethnicity, guideline-based care Citation Format: Roman Johnson, Mieke Beth Thomeer. Understanding the social determinants of guideline-based mammography adherence across race/ethnicity: Results from the 2016 California Health Interview Survey [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2022; 2022 Apr 8-13. Philadelphia (PA): AACR; Cancer Res 2022;82(12_Suppl):Abstract nr 37.