Initial and repeat mammography screening in a low income multi-ethnic population in Los Angeles

• Published in: Cancer epidemiology, biomarkers & prevention Vol. 4; no. 2; pp. 161 - 167
• Main Authors: Bastani, R, Kaplan, C P, Maxwell, A E, Nisenbaum, R, Pearce, J, Marcus, A C
• Format: Journal Article
• Language: English
• Published: United States American Association for Cancer Research 01-03-1995
• Subjects: Age Factors; Aged; Breast Diseases - diagnosis; Breast Neoplasms - diagnosis; Breast Neoplasms - prevention & control; Comprehensive Health Care - utilization; Ethnic Groups; Female; Follow-Up Studies; Health Services Needs and Demand; Hospitals - utilization; Humans; Los Angeles; Mammography - utilization; Mass Screening - utilization; Middle Aged; Poverty; Primary Health Care - utilization; Risk Factors; Los Angeles
• ISSN: 1055-9965; 1538-7755

Low income, older, minority women are at high risk for underutilization of screening mammography. One strategy for increasing
utilization is to conduct interventions targeting local and state health departments where a majority of these women seek
health care. A prerequisite for conducting effective screening programs is to obtain current and accurate information on baseline
screening rates to understand the nature and scope of the problem and to plan appropriate intervention strategies. The sample
consisted of 3240 women who were 50+ years of age from 2 hospitals and 2 comprehensive health centers operated by the Los
Angeles County Department of Health Services. Reviews of medical records indicated that only 21% of the sample had received
a mammogram in the 12 months prior to the clinic visit on which they were sampled and 23% of the sample received a mammogram
in the following 9 months. Approximately 5% of the total sample received a repeat mammogram in the 21-month period over which
they were tracked. Prospective independent predictors of screening were age, number of visits to primary care clinics, number
of visits to specialty care clinics, and history of breast abnormalities. The results underscore the importance of implementing
programs to increase mammography implementing programs to increase mammography screening within public facilities serving
low income multiethnic women. An important finding is that a large number of older women are seen in specialty clinics, which
represents an untapped resource for increasing screening in this population. Innovative interventions targeting such specialty
clinics could substantially contribute to increasing screening rates. A comprehensive approach targeting system, physician,
and patient barriers is recommended.