title: Are mammography recommendations in women younger than 40 related to increased risk?
abstract: Our objective was to examine the association between self-reported breast cancer risk factors and reported physician recommendations for mammography among women younger than 40. This study uses the 2005 National Health Interview Survey (NHIS) and includes 2,703 women ages 30-39 who reported having seen a doctor in the past 12 months. The NHIS is a population-based, cross-sectional survey of adult respondents in the United States. Overall, 19.0% of these women reported a recent mammography recommendation. Among women reporting no prior mammogram, women ages 30-34 with risk factors for breast cancer were more likely to report a recent mammogram recommendation than women without risk factors. There was no such association for women ages 35-39. Among women who reported a prior mammogram, risk factors were not associated with a recommendation for mammography; there was an association with age and recent clinical breast examination. Despite a lack of evidence-based guidelines for women under 40 years of age, these data suggest some younger women are being recommended for early mammography without indication. The relative benefits and harms of recommending mammography in this age group need further examination.
authors.affiliation: Department of Family and Community Medicine, University of Missouri, MA306 Medical Sciences Bldg, 1 Hospital Drive, Columbia, MO 65212, USA. kappj@health.missouri.edu
authors.forename: Julie M
authors.initials: JM
authors.lastname: Kapp
authors.forename: Bonnie C
authors.initials: BC
authors.lastname: Yankaskas
authors.forename: Michael L
authors.initials: ML
authors.lastname: LeFevre
mesh_terms: D000328:Adult; D000367:Age Factors; D001943:Breast Neoplasms / Q000000981:diagnostic imaging* / Q000453:epidemiology / Q000209:etiology; D003430:Cross-Sectional Studies; D019317:Evidence-Based Medicine; D005260:Female; D006306:Health Surveys; D006801:Humans; D016015:Logistic Models; D008327:Mammography / Q000706:statistics & numerical data*; D008403:Mass Screening / Q000706:statistics & numerical data*; D016017:Odds Ratio; D018579:Patient Selection; D017410:Practice Guidelines as Topic; D010818:Practice Patterns, Physicians'; D011237:Predictive Value of Tests; D018570:Risk Assessment; D012307:Risk Factors; D014481:United States / Q000453:epidemiology; D019564:Unnecessary Procedures