Minnesota healthcare providers’ breast cancer screening practices at the extremes of age.

Abstract

e13037 Background: Breast cancer screening guidelines disagree on the age to initiate and discontinue screening. We sought to determine the age at which Minnesota providers initiate and discontinue breast cancer screening. Methods: A cross-sectional online survey of Minnesota primary care providers was conducted in 2016. The survey queried providers’ breast screening practices for average-risk women. Data were summarized using descriptive statistics and comparisons by professional characteristics were conducted using Chi-squared tests. Results: There were 805 respondents (8% of 10,392 invitees), of which 456 (56.7%) provided primary care to women and were included in the analysis. 316 (72%) were women, 193 (44%) were physicians, 50 (11%) were physician assistants (PAs), and 197 (45%) were advanced practice nurses (APNs). 85% practiced in a community setting. 38% had practiced > 20 years, and 27% had practiced < 10 years. Among respondents, 67%, 77% and 72% recommended screening mammography for women age 40-44, 45-49 and 70+ years, respectively. Compared to male providers, female providers were more likely to screen women age 40-44 years (73% vs. 49%; p < 0.0001) and 45-49 years (81% vs. 66%; p = 0.002), but there was no difference by gender for patients age 70+ years (72% vs. 74%; p = 0.89). Respondents reporting specialized interest in women’s health were more likely to screen women age 40-44 years (73% vs. 61%; p = 0.006), 45-49 years (83% vs 72%; p = 0.007) and older than age 70 years (77% vs. 69%; p = 0.04). Physicians were less likely to screen women age 40-44 and 45-49 years (57% and 71%, respectively; p = 0.001) than PAs (72%, 78%) and APNs (74%, 83%), but APNs were less likely to screen women age 70+ years (65% vs. physicians 79% vs. PAs 76%; p = 0.006). Number of years in practice was not associated with a difference in age at initiation of screening, however, increasing number of years in practice was associated with screening women age 70+ years (p = 0.02). Conclusions: Although breast cancer screening practices for average risk women vary by healthcare provider characteristics, a majority of Minnesota primary care providers initiate breast cancer screening between ages 40-49 years, and continue screening women age 70 years and older.