F Tudiver1, E Fuller-Thomson. 1. Department of Family Medicine, State University of New York Health Science Center at Syracuse 13210, USA. tudiverf@mailbox.hscsyr.edu
Abstract
OBJECTIVE: To determine the characteristics of Canadian women aged 35 to 49 who receive screening mammograms not recommended by the Canadian Task Force on the Periodic Health Examination. DESIGN: Secondary data analysis of the 1994-1995 National Population Health Survey. SETTING: Patients' homes. PARTICIPANTS: From a full national representative sample of 17,626 Canadian residents, we selected 2053 women aged 35 to 49 with no breast problems. MAIN OUTCOME MEASURES: Age, education, employment status, marital status, immigrant status, region of residence, self-reported health status, having a regular doctor, smoking status, alcohol consumption, and having a confidant. RESULTS: Of the 2053 women in the sample, 825 (40.2%) had had a screening mammogram as part of a regular medical checkup; 1228 (59.8%) had never had one. Logistic analysis showed that respondents who were approaching age 50, had higher incomes, lived in Quebec, and had regular medical doctors were more likely to have screening mammograms. Statistical trends indicated that heavy drinkers were less likely and immigrants more likely to have mammograms (not significant at P < .01: P = .012 and P = .02, respectively). CONCLUSIONS: Most of these findings are consistent with those of other studies of women 50 and younger. The findings suggest that the patient variables associated with having mammograms in those younger than 50 might be similar to those in women older than 50. An important next step is to determine whether this pattern of use has more to do with younger patients' demand for screening or with physicians' ordering of tests. Further research is also needed to understand the dynamics of the doctor-patient relationship in this situation.
OBJECTIVE: To determine the characteristics of Canadian women aged 35 to 49 who receive screening mammograms not recommended by the Canadian Task Force on the Periodic Health Examination. DESIGN: Secondary data analysis of the 1994-1995 National Population Health Survey. SETTING:Patients' homes. PARTICIPANTS: From a full national representative sample of 17,626 Canadian residents, we selected 2053 women aged 35 to 49 with no breast problems. MAIN OUTCOME MEASURES: Age, education, employment status, marital status, immigrant status, region of residence, self-reported health status, having a regular doctor, smoking status, alcohol consumption, and having a confidant. RESULTS: Of the 2053 women in the sample, 825 (40.2%) had had a screening mammogram as part of a regular medical checkup; 1228 (59.8%) had never had one. Logistic analysis showed that respondents who were approaching age 50, had higher incomes, lived in Quebec, and had regular medical doctors were more likely to have screening mammograms. Statistical trends indicated that heavy drinkers were less likely and immigrants more likely to have mammograms (not significant at P < .01: P = .012 and P = .02, respectively). CONCLUSIONS: Most of these findings are consistent with those of other studies of women 50 and younger. The findings suggest that the patient variables associated with having mammograms in those younger than 50 might be similar to those in women older than 50. An important next step is to determine whether this pattern of use has more to do with younger patients' demand for screening or with physicians' ordering of tests. Further research is also needed to understand the dynamics of the doctor-patient relationship in this situation.