Predictors of screening mammography: implications for office practice.

Abstract

The completion of annual screening mammography and other preventive health services among women aged 50 years and older remains an important quality of care indicator. A biracial sample of 843 rural women (aged > or =50 years) from a population-based sample reported demographic and preventive health services utilization in the last year including the completion of screening mammography. Bivariate analysis and logistic regression were used to investigate the extent to which completion of other screening examinations, including Papanicolaou (Pap) smears and clinical breast examination, is associated with successful completion of mammography relative to demographic and health service variables. The completion of mammography was associated with age, race, education, health insurance, and the presence of a regular primary care physician, but the strongest predictors were the completion of a clinical breast examination and/or a Pap smear. Women who receive a clinical breast examination and/or a Pap smear appear far more likely to receive screening mammography, suggesting a synergy in screening services. The relative efficacy of interventions to increase the completion of clinical breast examinations as well as other age-appropriate preventive services during routine office visits or during a single preventive services office visit should be further explored in primary care settings. Residency programs should provide training on the successful incorporation of such services into office practice patterns in an effort to continually improve quality of care.