Impact of geography on mammography use in California.
OBJECTIVE
Despite its benefit, about 30% of women report that they did not have a recent mammogram. We examine impact of distance, rural-urban residence, and other characteristics on mammography screening rates.


METHODS
We linked data on 33,938 women aged 40-84 years from the 2003 and 2005 California Health Interview Survey with FDA data on the location of mammography facilities in California, and with socioeconomic and geographic variables from the 2000 Census. We use logistic regression models to estimate the impact of selected variables on a woman's probability of having had a recent mammogram and developed a new mapping scheme to help visualize differences in mammography use across California.


RESULTS
Though distance to a facility did not impact a woman's probability of having had a recent mammogram, women who resided in urban areas had somewhat higher screening rates than those living in more rural areas, as displayed on our map.


CONCLUSIONS
Our findings suggest that more research is needed on possible disparities in access to mammography between rural and non-rural areas in California. Therefore, data adequately powered to examine rural populations and to compare them with urban populations are needed.
Jackson
Monica C
MC
Department of Mathematics and Statistics, American University, 4400 Massachusetts Ave. NW, Washington, DC 20016, USA. monica@american.edu
Davis
William W
WW
Waldron
William
W
McNeel
Timothy S
TS
Pfeiffer
Ruth
R
Breen
Nancy
N
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001943:Breast Neoplasms / Q000175:diagnosis / Q000453:epidemiology; D002140:California / Q000453:epidemiology; D055088:Early Detection of Cancer / Q000706:statistics & numerical data; D005260:Female; D005843:Geography; D006801:Humans; D016015:Logistic Models; D008327:Mammography / Q000706:statistics & numerical data*; D008875:Middle Aged; D012424:Rural Population / Q000706:statistics & numerical data; D012959:Socioeconomic Factors; D014505:Urban Population / Q000706:statistics & numerical data