Breast cancer risk and provider recommendation for mammography among recently unscreened women in the United States.
OBJECTIVE
Many women with increased breast cancer risk have not been screened recently. Provider recommendation for mammography is an important reason many women undergo screening. We examined the association between breast cancer risk and reported provider recommendation for mammography in recently unscreened women.


METHODS
Cross-sectional study using 2000 National Health Interview Survey.


METHODS
In all, 1673 women ages 40 to 75 years without cancer who saw a health care provider in the prior year and had no mammogram within 2 years.


METHODS
We assessed breast cancer risk by Gail score and risk factors. We used multivariable logistic regression models in SUDAAN adjusted for age, race and illness burden, to examine the association between risk and reported recommendation for mammography within 1 year for all women and women ages 50 to 75 years.


RESULTS
Of 1673 recently unscreened women, 29% reported a recommendation. Twelve percent of women had increased Gail risk and of these recently unscreened, high-risk women, 25% reported a recommendation. After adjustment, high-risk women were not more likely to report a recommendation than average-risk women. Results were similar for women 50 to 75 years old. No individual breast cancer factors other than age were associated with reporting a recommendation.


CONCLUSIONS
Approximately 70% of recently unscreened women seen by a health care provider in the prior year reported no recommendation for mammography, regardless of breast cancer risk. This did not include women who received a recommendation and were screened. Increasing reported recommendation rates may represent an opportunity to increase screening participation among recently unscreened women, particularly for women with increased breast cancer risk.
Sabatino
Susan A
SA
Division of General Medicine and Primary Care, Beth Israel Deaconess Medical Center, Boston, MA, USA. bzo8@cdc.gov
Burns
Risa B
RB
Davis
Roger B
RB
Phillips
Russell S
RS
McCarthy
Ellen P
EP