Breast Cancer Screening Practices Research Articles

Breast cancer screening practices among users of county-funded health centers vs women in the entire community.

Breast cancer screening rates tend to be lower among women with lower income and/or education. Telephone surveys of random samples of women aged 50 to 75 who had visited five health centers (n = 795) and women in the same age group residing in the entire community (n = 404) were conducted in 1988. Despite the significantly lower socioeconomic level, a higher proportion of minority women, and a poorer knowledge of mammography, screening rates in the health center group were not lower than in the community sample. About half or more of the health center respondents had ever had a mammogram regardless of income, education, age, and ethnic group. Of the community respondents, 49% had ever had a mammogram, but the proportion varied significantly by income and education. Within the subgroup of women having annual incomes below $15,000, mammography use was actually higher among health center women; that is, 50% of health center vs 35% of community women reported ever having a mammogram and 31% vs 14%, respectively, reported having a mammogram in the past year. The findings demonstrate the importance of publicly funded health centers in achieving screening rates among the socioeconomically disadvantaged that are comparable to (or even higher than) those in the general population.

Knowledge, attitudes, and practices of breast and cervical cancer screening among Vietnamese women.

The Vietnamese are the fastest-growing Asian/Pacific Islander ethnic group in California. Data from Vietnam and elsewhere suggest that cervical cancer and breast cancer are major contributors to cancer morbidity and mortality among Vietnamese women. However, little is known about the cancer knowledge and screening practices of Vietnamese women. Using a structured 57-item written questionnaire, we conducted a mailed survey of 400 randomly selected Vietnamese adult women in San Francisco. Overall, 107 women responded (31%). Of the respondents, 54 (52%) indicated that there was little one could do to prevent cancer. More than a third (39%) thought that breast or cervical cancer could be caused by poor hygiene, and about one-third (29%) thought that these cancers could be contagious. Although virtually all (97%) had heard of cancer, one-third did not know that a breast lump could be a sign of breast cancer (37%) or that abnormal vaginal bleeding could be a sign of cervical cancer (39%). Many (55%) did not know that family history was a risk factor for breast cancer and three-fourths (74%) did not know that having multiple sexual partners was a risk factor for cervical cancer. Fourteen (13%) had not heard of breast self-examination. Of 31 women aged > or = 40, 10 (34%) had never had a mammogram, and of 92 women aged > or = 18, 50 (54%) had never had a Papanicolaou test.(ABSTRACT TRUNCATED AT 250 WORDS)

Breast cancer screening among relatives of women with breast cancer.

National surveys indicate that only 15% to 30% of all women in the general population 50 years of age or older have an annual mammogram. We studied first-degree female relatives of women with breast cancer, who are at elevated risk of disease, to describe the breast cancer screening practices of these relatives and to improve their practices through a program of intensive education. We report here the screening behaviors of 2471 relatives of women with breast cancer. Self-reported behaviors were as follows: 49% performed monthly breast self-examination and 70% had annual breast examinations by a medical professional. Of 983 women 50 years of age or older, 49% had had a mammogram, but only 14% have a mammogram annually. Of women 50 years of age or older who had never had a mammogram, 92% reported never having had one recommended by a medical professional. Our findings indicate that screening behaviors in relatives of breast cancer patients are not substantially different from those of women in the general population. Enhanced efforts both to educate medical professionals and to encourage women to demand screening mammography are necessary to reduce breast cancer mortality.

Role of the general practitioner in breast cancer screening in the netherlands

Following the advice of the Dutch National Health Council, a national screening program for breast cancer was started in 1990 in the Netherlands. All women aged 50-70 will be invited for screening by mammography in fixed or (semi)mobile screening units every 2 years. The role of the general practitioner in screening for breast cancer is described in the Dutch protocol (Standard) published in 1990 by the Dutch College of General Practitioners. Because of the role of the general practitioner/family doctor as a gatekeeper and because of the list system, every Dutch woman is known by her own general practitioner. In any given year the general practitioner will see 70% of his population. So the general practitioner is in the position to play an important role in practice and patient-centered support of breast cancer screening. The general practitioner also has an important role in the support of women with positive results. The general practitioner receives the "abnormal" results and has to explain to the woman what this means and what further investigations are necessary. There are teaching programs on screening for breast cancer for the vocational training of general practitioners and for postgraduate training.

Breast Cancer Screening in Older Women: Practices and Barriers Reported by Primary Care Physicians

Annual mammography, in combination with clinical breast examinations, can reduce mortality from breast cancer. However, surveys of both patients and physicians suggest that mammography is underutilized. This study examined whether physicians' reported breast cancer screening practices and barriers to mammography varied with patients' age. Data from 576 primary care physicians (internal medicine, family/general practice, and obstetrics/gynecology) who participated in a mailed statewide survey were analyzed. Physicians reported screening elderly women significantly less often than younger women, regardless of family history of breast cancer. With the exception of medical specialty, physicians' demographic and practice characteristics were not associated with reported screening practices. However, physicians' knowledge and beliefs about breast cancer in older women were associated with reported screening practices. When analyzing barriers to ordering mammography, cost to the patient was viewed as a barrier for women of all ages, and pain was viewed as a greater barrier for younger women; otherwise, physicians consistently believed that their elderly patients faced considerably more barriers compared with younger women. Further investigation is required to examine why primary care physicians report age-related differences in both breast screening and barriers to mammography.