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September 27, 1993

Frequency and Determinants of Screening for Breast Cancer in Primary Care Group Practice

Author Affiliations

From the Cancer Prevention Program, University of Wisconsin Comprehensive Cancer Center, and the Departments of Human Oncology (Drs Love and Fontana) and Family Medicine and Practice (Drs Love, Brown, Davis, and Sanner) and the School of Nursing (Drs Baumann and Brown), Center for Health Sciences, University of Wisconsin-Madison.

Arch Intern Med. 1993;153(18):2113-2117. doi:10.1001/archinte.1993.00410180059006

Background:  Many studies reporting the frequency of breast cancer screening have been based only on physician and patient surveys or on data from quality assurance studies and do not assess the reliability of information obtained from these various sources.

Methods:  To obtain more complete data we studied mammography performed in a 3-year period, 1988 through 1991, in 24 nonacademic primary care group practices by both auditing the medical records and obtaining questionnaire responses from 1819 women aged 53 to 62 years and from their 98 physicians in the nonmetropolitan Midwest.

Results:  Medical record data indicated that mammography was performed in all 3 years in 16.7%, in at least two of 3 years in 49.8%, and in at least one of 3 years in 81.7% of women. While patient reports of a family history of breast cancer, health insurance coverage for mammography, and greater annual household income were each significant predictors, a patient report that a clinic staff member had discussed mammography was the strongest predictor of greater frequency of mammography.

Conclusions:  In this study of self-selected physicians and their patients, record-documented mammographic examinations were considerably more frequent than has been reported in some studies, but occurred at rates consistent with quality assurance data for the region. These data suggest that clinic staff initiatives with screening mammography have a large impact.(Arch Intern Med. 1993;153:2113-2117)