title: Breast cancer screening beliefs by practice location.
abstract: BACKGROUND
  This study examines variations in breast cancer screening among primary care clinicians by geographic location of clinical practice.
  
  
  METHODS
  A cross-sectional survey design was used to examine approaches to breast cancer screening among physicians, nurse practitioners, and physician assistants involved in primary care practice. A summary index of beliefs about breast cancer screening was created by summing the total number of responses in agreement with each of four survey items; values for this summary variable ranged between zero and four. Respondents were classified into urban, rural and suburban categories based upon practise location.
  
  
  RESULTS
  Among the 428 respondents, agreement with "correct" responses ranged from 50% to 71% for the individual survey items; overall, half agreed with three or more of the four breast cancer screening items. While no significant differences were noted by practice location, variation in responses were evident. Reported use of written breast cancer guidelines was less in both suburban (OR = 0.51) and urban areas (OR = 0.56) when compared to clinicians in rural areas.
  
  
  CONCLUSIONS
  Development of an evidence-based consensus statement regarding breast cancer screening would support a single set of unambiguous guidelines for implementation in all primary care settings, thus decreasing variations in how breast cancer screening is approached across varied clinical settings.
authors.affiliation: Department of Family Medicine, University of Miami/Jackson Memorial Health System, Miami, Florida 33136, USA. lisasantora@hotmail.com
authors.forename: Lisa M
authors.initials: LM
authors.lastname: Santora
authors.forename: Martin C
authors.initials: MC
authors.lastname: Mahoney
authors.forename: Silvana
authors.initials: S
authors.lastname: Lawvere
authors.forename: Jessica J
authors.initials: JJ
authors.lastname: Englert
authors.forename: Andrew B
authors.initials: AB
authors.lastname: Symons
authors.forename: Amy L
authors.initials: AL
authors.lastname: Mirand
mesh_terms: D001291:Attitude of Health Personnel; D001943:Breast Neoplasms / Q000000981:diagnostic imaging*; D003430:Cross-Sectional Studies; D005260:Female; D019538:Health Care Surveys; D006801:Humans; D008327:Mammography / Q000706:statistics & numerical data*; D008403:Mass Screening / Q000706:statistics & numerical data*; D009518:New York; D009722:Nurse Practitioners; D010823:Physician Assistants; D010821:Physicians, Family; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D011320:Primary Health Care / Q000592:standards*; D011365:Professional Practice Location / Q000706:statistics & numerical data*