title: Factors associated with annual-interval mammography for women in their 40s.
abstract: BACKGROUND
  Evidence is mounting that annual mammography for women in their 40s may be the optimal schedule to reduce morbidity and mortality from breast cancer. Few studies have assessed predictors of repeat mammography on an annual interval among these women.
  
  
  METHODS
  We assessed mammography screening status among 596 insured Black and Non-Hispanic white women ages 43-49. Adherence was defined as having a second mammogram 10-14 months after a previous mammogram. We examined socio-demographic, medical and healthcare-related variables on receipt of annual-interval repeat mammograms. We also assessed barriers associated with screening.
  
  
  RESULTS
  44.8% of the sample were adherent to annual-interval mammography. A history of self-reported abnormal mammograms, family history of breast cancer and never having smoked were associated with adherence. Saying they had not received mammography reminders and reporting barriers to mammography were associated with non-adherence. Four barrier categories were associated with women's non-adherence: lack of knowledge/not thinking mammograms are needed, cost, being too busy, and forgetting to make/keep appointments.
  
  
  CONCLUSIONS
  Barriers we identified are similar to those found in other studies. Health professionals may need to take extra care in discussing mammography screening risk and benefits due to ambiguity about screening guidelines for women in their 40s, especially for women without family histories of breast cancer or histories of abnormal mammograms. Reminders are important in promoting mammography and should be coupled with other strategies to help women maintain adherence to regular mammography.
authors.affiliation: Department of General Internal Medicine, Duke University Medical Center, Durham, NC 27707, USA. j.gierisch@duke.edu
authors.forename: Jennifer M
authors.initials: JM
authors.lastname: Gierisch
authors.forename: Suzanne C
authors.initials: SC
authors.lastname: O'Neill
authors.forename: Barbara K
authors.initials: BK
authors.lastname: Rimer
authors.forename: Jessica T
authors.initials: JT
authors.lastname: DeFrank
authors.forename: J Michael
authors.initials: JM
authors.lastname: Bowling
authors.forename: Celette Sugg
authors.initials: CS
authors.lastname: Skinner
mesh_terms: D000328:Adult; D001294:Attitude to Health; D001943:Breast Neoplasms / Q000175:diagnosis*; D005260:Female; D015438:Health Behavior; D019538:Health Care Surveys; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D016015:Logistic Models; D008327:Mammography / Q000523:psychology / Q000706:statistics & numerical data*; D008403:Mass Screening / Q000523:psychology / Q000706:statistics & numerical data; D008875:Middle Aged; D010349:Patient Compliance; D012959:Socioeconomic Factors; D013997:Time Factors