Physician recommendations for mammography in women aged 70 and older.
OBJECTIVE
To estimate the percentage of U.S. women aged 70 and older who reported a recent mammography recommendation and to identify whether factors suggesting limited life expectancy, such as comorbidities, are associated with a lower probability of a reported recommendation.


METHODS
A national, population-based, cross-sectional survey.


METHODS
United States.


METHODS
There were 1,782 screen-eligible women 70 and older who responded to the National Health Interview Survey in 2005 and met eligibility criteria, including reporting at least one doctor visit in the previous 12 months. Weighted, these women represented almost 9.3 million women nationally.


METHODS
Multiple logistic regression was used to examine the relationship between demographic, comorbidity, and health services utilization variables on self-reported physician recommendation for a mammogram.


RESULTS
More than half (58.9%) of the sample reported a recent mammography recommendation (63.0% of those aged 70 to 79 and 51.5% of those aged 80 and older). The strongest multivariable association suggested that women who reported a recent clinical breast examination (CBE) had 5.9 times greater odds of reporting a mammography recommendation than women who reported never having a CBE.


CONCLUSIONS
This study failed to find negative associations between factors suggesting limited life expectancy and a recent mammography recommendation. Instead, findings revealed a strong positive association between a recent CBE and mammography recommendation. Findings may suggest that recent clinical interactions weigh more heavily on a decision to recommend mammography to older, screen-eligible women than considerations for the woman's overall long-term health or may reflect a greater perceived or actual recall of physician recommendations from women with a recent CBE.
Kapp
Julie M
JM
Department of Family and Community Medicine, University of Missouri, Columbia, Missouri, USA. kappj@health.missouri.edu
Lemaster
Joseph W
JW
Zweig
Steven C
SC
Mehr
David R
DR
D000203:Activities of Daily Living; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D003430:Cross-Sectional Studies; D005260:Female; D019538:Health Care Surveys; D006304:Health Status; D006801:Humans; D008327:Mammography; D008403:Mass Screening; D010342:Patient Acceptance of Health Care; D018579:Patient Selection; D017410:Practice Guidelines as Topic