The gynecologist's role in mammography screening in absence of a public health program.
This study examined the role of the gynecologist in a woman's adoption of mammography screening in a population that does not benefit from an organized program of breast cancer screening. We surveyed 486 women ages 50-69 years, randomly selected from the population of Geneva (Switzerland) about recent mammography use, attitudes toward mammography screening (decisional balance), whether they received a recommendation to undergo mammography from their gynecologist and/or family practitioner, visits to gynecologist and family practitioner, and sociodemographic variables. In multivariate analysis, on-schedule mammography was associated with a recent visit to a gynecologist (odds ratio (OR) 4.8, 95% confidence interval (CI) 2.1-10.9), a gynecologist's recommendation for mammography (OR 15.8, 95% CI 6.5-38.6), a positive attitude toward mammography screening (positive score of decisional balance, OR 1.7, 95% CI 1.0-3.0), and being married (OR 2.0, 95% CI 1.2-3.3). Higher decisional balance scores were associated with a recent visit to a gynecologist ( P=0.001), a gynecologist's recommendation for mammography (P=0.001), and income ( P=0.01). Both a recent visit to a gynecologist and a gynecologist's recommendation for mammography were more frequent in women of higher income. This study suggests that gynecologists--but not family practitioners--play a key role both in referring women for mammography and in fashioning women's perceptions of mammography screening. Our data also indicate that a lack of access to a gynecologist and not receiving a gynecologist's recommendation for mammography may explain why low-income women are less likely to get a screening mammogram.
Chamot
Eric
E
Institute of Social and Preventive Medicine, University of Geneva, Switzerland. echamot@uab.edu
Perneger
Thomas V
TV
D000368:Aged; D005260:Female; D006176:Gynecology; D019538:Health Care Surveys; D006266:Health Education; D006801:Humans; D008327:Mammography / Q000523:psychology* / Q000706:statistics & numerical data*; D008403:Mass Screening / Q000379:methods; D008875:Middle Aged; D010342:Patient Acceptance of Health Care / Q000523:psychology*; D010819:Physician's Role; D010821:Physicians, Family; D015980:Public Health Practice; D011897:Random Allocation; D012017:Referral and Consultation; D013557:Switzerland