title: Predictors of Non-Adherence to Breast Cancer Screening among Hospitalized Women.
abstract: OBJECTIVE
  Disparities in screening mammography use persists among low income women, even those who are insured, despite the proven mortality benefit. A recent study reported that more than a third of hospitalized women were non-adherent with breast cancer screening. The current study explores prevalence of socio-demographic and clinical variables associated with non-adherence to screening mammography recommendations among hospitalized women.
  
  
  METHODS
  A cross sectional bedside survey was conducted to collect socio-demographic and clinical comorbidity data thought to effect breast cancer screening adherence of hospitalized women aged 50-75 years. Logistic regression models were used to assess the association between these factors and non-adherence to screening mammography.
  
  
  RESULTS
  Of 250 enrolled women, 61% were of low income, and 42% reported non-adherence to screening guidelines. After adjustment for socio-demographic and clinical predictors, three variables were found to be independently associated with non-adherence to breast cancer screening: low income (OR = 3.81, 95%CI; 1.84-7.89), current or ex-smoker (OR = 2.29, 95%CI; 1.12-4.67), and history of stroke (OR = 2.83, 95%CI; 1.21-6.60). By contrast, hospitalized women with diabetes were more likely to be compliant with breast cancer screening (OR = 2.70, 95%CI 1.35-5.34).
  
  
  CONCLUSIONS
  Because hospitalization creates the scenario wherein patients are in close proximity to healthcare resources, at a time when they may be reflecting upon their health status, strategies could be employed to counsel, educate, and motivate these patients towards health maintenance. Capitalizing on this opportunity would involve offering screening during hospitalization for those who are overdue, particularly for those who are at higher risk of disease.
authors.affiliation: Department of Medicine, Johns Hopkins Bayview Medical Center, Johns Hopkins University, School of Medicine, Baltimore, Maryland, United States of America.
authors.forename: Waseem
authors.initials: W
authors.lastname: Khaliq
authors.affiliation: Department of Internal Medicine, Yale-Waterbury Hospital, Yale School of Medicine, Waterbury, Connecticut, United States of America.
authors.forename: Ali
authors.initials: A
authors.lastname: Aamar
authors.affiliation: Department of Medicine, Johns Hopkins Bayview Medical Center, Johns Hopkins University, School of Medicine, Baltimore, Maryland, United States of America.
authors.forename: Scott M
authors.initials: SM
authors.lastname: Wright
mesh_terms: D000368:Aged; D001943:Breast Neoplasms / Q000175:diagnosis* / Q000453:epidemiology; D015897:Comorbidity; D005260:Female; D006760:Hospitalization; D006801:Humans; D008327:Mammography / Q000706:statistics & numerical data; D008403:Mass Screening / Q000706:statistics & numerical data*; D008875:Middle Aged; D010349:Patient Compliance / Q000706:statistics & numerical data*; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires