title: Predictors of mammography use in older women with disability: the patients' perspectives.
abstract: To determine the factors associated with mammography use among Medicare beneficiaries and reasons for nonuse. Cohort of 4610 community-dwelling Medicare beneficiaries ≥ 65 years included in the 2004-2005 Medicare Current Beneficiary Survey. Regression models evaluated the association of disability with mammography use. Reasons for underuse are described. Women with disability were more likely than women with no disability to report lower mammography use (unadjusted, moderate disability OR = 0.76; 95% CI = 0.64, 0.91; severe disability OR = 0.46; 95% CI = 0.40, 0.54). Lower use was significant for women with severe disability (adjusted, OR = 0.67; 95% CI = 0.54, 0.83) and women with fair-poor self-rated health, no HMO enrollment and ≥ 3 comorbidities. No physician recommendation, no need, dislike/pain during the test and forget it were reasons for underutilization. Mammography use decreases with increasing level of disability. Common reasons for underutilization are no physician recommendation, no need, dislike/pain during the test and forgot it. Screening guidelines should be used to target women with disabilities who can benefit from mammography.
authors.affiliation: Department of Physical Medicine and Rehabilitation, University of Texas Southwestern Medical Center, 5323 Harry Hines Boulevard, Mail Stop 9055, Dallas, TX 75390-9055, USA. mabel.caban@utsouthwestern.edu
authors.forename: Mabel
authors.initials: M
authors.lastname: Caban
authors.forename: Yong Fang
authors.initials: YF
authors.lastname: Kuo
authors.forename: Mukaila
authors.initials: M
authors.lastname: Raji
authors.forename: Alai
authors.initials: A
authors.lastname: Tan
authors.forename: Jean
authors.initials: J
authors.lastname: Freeman
mesh_terms: D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D001943:Breast Neoplasms / Q000175:diagnosis / Q000453:epidemiology / Q000523:psychology; D015331:Cohort Studies; D006233:Persons with Disabilities / Q000523:psychology*; D005260:Female; D006801:Humans; D008327:Mammography / Q000523:psychology* / Q000706:statistics & numerical data*; D006278:Medicare / Q000706:statistics & numerical data*; D057240:Patient Preference / Q000523:psychology*; D011237:Predictive Value of Tests; D014481:United States / Q000453:epidemiology