title: Women's primary care providers and breast cancer screening: who's following the guidelines?
abstract: OBJECTIVE
  Screening mammography for woman ages 50 to 69 years has resulted in early breast cancer detection and reduced mortality rates. However, the providers who are responsible for women's preventive health care differ in breast cancer screening guideline adherence. We compared screening practices across provider specialty and training degree types.
  
  
  METHODS
  Using a retrospective cohort design, we examined 472 patient records that represented 16 million preventive health care visits among women ages 50 to 69 years from the 2000 National Ambulatory Medical Care Survey. We calculated relative risk ratios for breast examination and mammography during preventive visits across provider specialty and training types.
  
  
  RESULTS
  Among specialists, gynecologists are more likely than internists or general/family practitioners to follow breast cancer screening guidelines. Across training degree types, mid-level providers are more likely than medical doctors or osteopaths to adhere to guidelines.
  
  
  CONCLUSIONS
  Regardless of specialty type or training degree, women's health care providers should adhere to breast cancer screening guidelines during preventive care visits.
authors.affiliation: VA Outcomes Group REAP, VA Medical Center, White River Junction, VT 05009-0001, USA. amy.e.wallace@dartmouth.edu
authors.forename: Amy E
authors.initials: AE
authors.lastname: Wallace
authors.forename: Todd A
authors.initials: TA
authors.lastname: MacKenzie
authors.forename: William B
authors.initials: WB
authors.lastname: Weeks
mesh_terms: D000368:Aged; D001943:Breast Neoplasms / Q000175:diagnosis* / Q000517:prevention & control; D016504:Breast Self-Examination / Q000706:statistics & numerical data*; D015331:Cohort Studies; D005194:Family Practice; D005260:Female; D019983:Guideline Adherence; D006176:Gynecology; D006801:Humans; D007388:Internal Medicine; D008327:Mammography / Q000706:statistics & numerical data*; D008875:Middle Aged; D010818:Practice Patterns, Physicians'; D011320:Primary Health Care; D012189:Retrospective Studies