The effect of family history on adherence to breast cancer screening guidelines.

Abstract

1571 Background: A family history of breast cancer increases the risk of developing this disease. We sought to determine the effect of a family history of a first degree relative with breast cancer (FDFHx) on adherence to mammography (MMG) and clinical breast examination (CBE) guidelines. Methods: The National Health Interview Survey (NHIS), conducted annually by the Centers for Disease Control, is designed to be representative of the US population. The 2010 NHIS data was used to evaluate the effect of FDFHx on the likelihood that women aged ≥ 30 had MMG and/or CBE within the past year. Results: Of the 12,320 women aged ≥ 30, 1276 (10.7%) had a FDFHx; 1263 (99.0%) of female breast cancer and 13 (1.0%) of male breast cancer. Overall, 4573 (38.4%) of women reported having had MMG within the past year; 5377 (46.3%) had CBE within the past year. FDFHx was associated with use of MMG and CBE within the past year (58.0% vs. 36.0%, p<0.001, and 57.5% vs. 45.0%, p<0.001, respectively). Women with a FDFHx of male breast cancer were no more likely to have MMG (72.5% vs. 57.9%, p=0.313) nor CBE (66.8% vs. 57.4%, p=0.518) within the past year than those with a FDFHx of female breast cancer. On multivariate analysis controlling for age, race, personal history of breast cancer (PHx), income, insurance, education and region, FDFHx was associated with a higher likelihood of having MMG (OR=1.75; 95% CI: 1.48-2.06, p<0.001) and CBE (OR=1.48; 95% CI: 1.26-1.74, p<0.001) within the past year. Region was not associated with adherence to either MMG or CBE screening guidelines. Conclusions: FDFHx, along with age, race, PHx, income, insurance, and education, is an independent predictor of adherence to screening MMG and CBE guidelines. Still, only 58% of women with a FDFHx had MMG and CBE in the past year. Further efforts are warranted to improve screening in this population at increased risk. [Table: see text]