Disparities in adherence to recommended followup on screening mammography: interaction of sociodemographic factors.
OBJECTIVE
The objective of this study was to examine disparities in adherence to screening mammography and, specifically, to investigate whether race/ethnicity, education, age, health insurance, and family history of breast cancer (FHBC), as unique factors and in interactions, influence adherence to recommended follow up on screening mammography.


METHODS
The study involved retrieval and analyses of data collected by the Colorado Mammography Project (CMAP) for 167,232 diverse (82.8% White, 3.4% Black, 11% Hispanic, 1.6% Asian, 0.6% Native American, and 0.6% "other") screening participants during the 1990-1997 study period.


METHODS
Subjects' first mammograms captured by CMAP were tracked in the database to identify women who received follow-up recommendations, women who adhered within 12 months and those that did not. Analyses included comparisons of adherence rates among women with various sociodemographic characteristics.


RESULTS
Of the 17,358 women who received follow-up recommendations, 80.7% adhered. Overall, non-White women in each of the racial/ethnic groups were less likely to adhere to recommendations than were White women (P<.05). Also less likely to adhere were the younger, less educated, uninsured/underinsured, and women who reported not having FHBC.


CONCLUSIONS
Race/ethnicity appeared to interact with age, education, health insurance, and FHBC to influence the probability of adherence, suggesting the need to explore further cultural, psychosocial, and situational factors.
Strzelczyk
Jadwiga Jodi
JJ
Department of Radiology, University of Colorado, Health Sciences Center, School of Medicine, Denver 80262, USA. jodi.strzelczyk@uchsc.edu
Dignan
Mark B
MB
D000328:Adult; D001741:Black or African American / Q000706:statistics & numerical data*; D000367:Age Factors; D000368:Aged; D001294:Attitude to Health / Q000208:ethnology*; D001943:Breast Neoplasms / Q000208:ethnology* / Q000517:prevention & control*; D015331:Cohort Studies; D003120:Colorado / Q000453:epidemiology; D016001:Confidence Intervals; D005006:Ethnicity; D005260:Female; D005500:Follow-Up Studies; D015438:Health Behavior; D006801:Humans; D008327:Mammography / Q000592:standards / Q000706:statistics & numerical data*; D008403:Mass Screening / Q000592:standards*; D008875:Middle Aged; D010349:Patient Compliance / Q000208:ethnology* / Q000706:statistics & numerical data*; D011336:Probability; D012042:Registries; D012307:Risk Factors; D012424:Rural Population; D012959:Socioeconomic Factors; D014505:Urban Population; D044465:White People / Q000706:statistics & numerical data*