Determinants of the demand for breast cancer screening among women veterans in the United States.

Demand theory has been applied to use of breast exams for cancer prevention, but not since widespread promotion of mammography screening and managed care. Previous economic analyses may be biased due to inclusion of diagnostic exams and generally fail to consider perceived risk and time costs. The objective was to identify and measure the effect of economic, demographic, and behavioral factors that influence the use of mammography screening among US women veterans aged 50 years and older. Data are from a 2000-2001 national mail survey with telephone follow-up of a random sample of women veterans. There were a maximum of 3415 respondents aged 50 and over with no history of breast cancer. Maximum likelihood probit models were used to estimate the effects of the independent variables on the probability that a woman will have had a mammogram in the past year. Education, income, insurance, and perceived risk of breast cancer are directly related to use of mammography screening. Age, smoking, travel and waiting time are inversely related to the likelihood of mammography screening. Mammography use among women veterans is generally consistent with the theory of the demand for health and medical care, and also consistent with previous national studies on the demand for breast exams. Findings highlight the role of perceived risk and non-price barriers to mammography use in the context of widespread insurance coverage for mammography screening.