The association between visiting a primary care provider and uptake of periodic mammograms as women get older.
To determine whether visits to a primary care provider (PCP) are associated with the uptake of periodic mammograms as women get older.



The cohort consisted of 2,389,889 women resident in Ontario, Canada, aged 50 to 79 at any point from 2001 to 2010, who were cancer-free and eligible for the Ontario Health Insurance Plan prior to study entry. Non-parametric estimation was used to describe the mean cumulative number of periodic mammograms for women with and without recent exposure to a PCP, as a function of age. Using age as the time scale, a recurrent event regression model was also implemented to examine the association between exposure to a PCP and rate of periodic mammograms, adjusted for income quintile and comorbidity.



The mean observation window was 7.0 years. Uptake of periodic mammograms was significantly higher for women with recent exposure to a PCP compared with those without. This trend remained consistent as women aged, and the magnitude of the association increased for women aged 65 or older. The relative rate of periodic mammograms was lower than 1 and consistently decreased as women from lower income quintiles were compared with women from the wealthiest quintile.



Visits to a PCP play an important role in uptake of periodic mammograms, and this association increases as women age.
Institute for Clinical Evaluative Sciences, Toronto Institute for Health Policy, Management, and Evaluation, University of Toronto Department of Biostatistics, Dalla Lana School of Public Health, University of Toronto rinku.sutradhar@ices.on.ca.
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Sutradhar
Institute for Clinical Evaluative Sciences, Toronto.
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Institute for Clinical Evaluative Sciences, Toronto Institute for Health Policy, Management, and Evaluation, University of Toronto Centre for Research on Inner City Health, Li Ka Shing Knowledge Institute, St. Michael's Hospital Department of family medicine, University of Toronto and St. Michael's Hospital.
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Glazier
Institute for Clinical Evaluative Sciences, Toronto Institute for Health Policy, Management, and Evaluation, University of Toronto Sunnybrook Research Institute, Toronto.
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Paszat
D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D001943:Breast Neoplasms / Q000000981:diagnostic imaging* / Q000517:prevention & control; D015331:Cohort Studies; D015897:Comorbidity; D005260:Female; D006801:Humans; D008327:Mammography / Q000706:statistics & numerical data*; D008875:Middle Aged; D009864:Ontario; D010342:Patient Acceptance of Health Care; D011320:Primary Health Care; D014932:Women's Health Services
periodic mammograms; primary care provider; recurrent event model; relative rate; time-varying covariates; uptake