Physician and patient characteristics associated with outpatient breast cancer screening recommendations in the United States: analysis of the National Ambulatory Medical Care Survey Data 1996–2004

Abstract

The primary goal of breast cancer screening tests is to find cancer at an early stage before a person has any symptoms. Evidence suggests that screening examinations such as mammography and clinical breast examinations (CBE) are effective in early detection of breast cancer. Physician recommendation is an important reason many women undergo screening. This study examined the physician and patients related factors associated with physician recommendations for breast cancer screening in the United States (US) outpatient settings. This cross-sectional study used data from the National Ambulatory Medical Care Survey (NAMCS) from 1996-2004. Women aged >or=40 years were included in the study sample. Multivariate logistic regression analyses were used to study the objectives. Weighted analysis indicated that physicians performed 198 million CBEs and made 110 million mammography recommendations over the study period (1996-2004). Patients' age, duration of visits, history of previous breast cancer diagnosis, and source of insurance were significant predictors of screening recommendations in this population. Obstetricians and gynecologists were more likely to perform a CBE and recommend mammography than other specialty physicians. These findings indicated that there were certain disparities regarding the physician recommendations of breast cancer screening for women in the US outpatient settings.