Mammography screening: how important is cost as a barrier to use?
OBJECTIVE
Recent legislation will improve insurance coverage for screening mammography and effectively lower its cost to many women. Although cost has been cited as a barrier to use, evidence of the magnitude of its effect on use is limited.


METHODS
Mammography use in the past 2 years among women aged 50 to 75 residing in four suburban or rural counties in Washington State was estimated from 1989 survey data. Logistic regression analysis was used to estimate the odds ratio of mammography use as a function of economic and other variables. Within a residential area, averages were used to measure the market price of mammography and the time cost to obtain a mammogram.


RESULTS
Use was lower among women who faced a higher net price or who preferred to obtain a mammogram during weekend or evening hours and higher among women with higher incomes. Visiting no doctor regularly and smoking were predictors of failure to use mammography.


CONCLUSIONS
The effects of economic variables on mammography use are important and stable across subsets of the population, but they are modest in size.
Urban
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Cancer Prevention Research Program, Fred Hutchinson Cancer Research Center, Seattle, WA 98104.
Anderson
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Peacock
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D000368:Aged; D001943:Breast Neoplasms / Q000000981:diagnostic imaging* / Q000517:prevention & control; D003365:Costs and Cost Analysis; D005260:Female; D006801:Humans; D008327:Mammography / Q000191:economics* / Q000706:statistics & numerical data; D008403:Mass Screening / Q000191:economics; D008875:Middle Aged; D015999:Multivariate Analysis; D016017:Odds Ratio; D010342:Patient Acceptance of Health Care / Q000706:statistics & numerical data*; D014861:Washington