Predicting repeat mammography screening for underserved women 50 years of age and older in Missouri.

摘要

Backgound. Breast cancer is the most common cancer occurring among women in Missouri representing 16.1% of the total cancer incidence and 8.2% of the total cancer mortality in the state. Regular mammography has been shown to decrease the breast cancer mortality rate by 20 to 39% in women 50 to 74 years of age. Although a statewide program provides mammography services for program-eligible women at no cost to the participants, compliance with the recommendation of annual mammography screening for women 50 years of age and older has remained low (35.9%; 1993--1995).;Purpose. The primary purpose of this study was to determine which characteristics from selected demographic variables, risk factors, past health history, previous clinical procedures, and prescreening health care belief constructs most predict returning or not returning for a repeat mammography screening. Additional purposes were to determine the essential questions of the Feelings About Health Care questionnaire for development of the prescreening belief constructs and to determine if interactions existed between the belief constructs and other factors contributing to women returning or not returning for repeat mammography screening.;Procedure. Data from 1,073 women, 50 years of age or older, participating in the Missouri Breast and Cervical Cancer Control Program were analyzed using Cohen's kappa measure of agreement, chi square analysis, and logistic regression to determine which characteristics significantly predicted which women did not return for repeat mammography screening.;Results. Seventy-two percent (18) of the Feelings About Health Care questions were found reliable and were used to develop the belief constructs. The belief constructs along with other potential predictive variables were modeled using logistic regression analyses. The findings from the best continuous variable logistic regression model indicated that seven variables significantly predicted not returning for repeat mammography: (1) aged 65 or older, (2) African American or other racial/ethnic minority, (3) referral from a source other than one's self or a health care provider, (4) mammography received in a metropolitan statistical area, (5) no previous clinical breast examination, (6) a high perception of barriers and a need for information, and (7) a low perception of susceptibility. In addition, the most parsimonious logistic regression model indicated that being single/divorced/separated/widowed was also a statistically significant predictor of not returning for repeat mammography screening.