Utilization of Screening Mammography in Women Before 50: Cross-Sectional Survey Results from the National Health Interview Survey.

Autor:	Vengalasetti YV; Department of Epidemiology and Population Health, Stanford University School of Medicine, Stanford, CA., Narayan AK; Department of Radiology, University of Wisconsin-Madison, Madison, WI., Brown CA; School of Medicine, Meharry Medical College, Nashville, TN., Boakye-Ansa N; School of Medicine, Meharry Medical College, Nashville, TN., Strigel RM; Department of Radiology, University of Wisconsin-Madison, Madison, WI., Elezaby MA; Department of Radiology, University of Wisconsin-Madison, Madison, WI., Martin MD; Department of Radiology, University of Wisconsin-Madison, Madison, WI., Woods RW; Department of Radiology, University of Wisconsin-Madison, Madison, WI., Flores EJ; Department of Radiology, Harvard Medical School, Harvard University, Boston, MA., Miles RC; Denver Health Hospital, Denver, CO. Electronic address: Randy.Miles@dhha.org.
Jazyk:	angličtina
Zdroj:	Academic radiology [Acad Radiol] 2023 Jun; Vol. 30 (6), pp. 1101-1106. Date of Electronic Publication: 2022 Aug 12.
DOI:	10.1016/j.acra.2022.07.014
Abstrakt:	Objective: While the American College of Radiology recommends annual screening mammography starting at age 40 years, the US Preventive Services Task Force (USPSTF) recommends that screening mammography in women younger than age 50 years should involve shared- decision making (SDM) between clinicians and patients, considering benefits and potential harms in younger women. Using a nationally representative cross-sectional survey, we aimed to evaluate patient-reported reasons and predictors of screening mammography utilization in this age group. Methods: Respondents aged 40-49 years from the 2018 National Health Interview Survey (NHIS) without a history of breast cancer were included (response rate 64%). Participants reported sociodemographic variables and reasons they did not engage in mammography screening within the last two years. Multiple variable logistic regression analyses were performed to evaluate the association between sociodemographic characteristics and patient-reported screening mammography use, accounting for complex survey sampling design elements. Results: 1,948 women between the ages of 40-49 years were included. Of this group, (758/1948) 46.6% reported receiving a screening mammogram within the last year, and 1196/1948 (61.4%) reported receiving a screening mammogram within the last two years. The most common reasons for not undergoing screening included: "No reason/never thought about it" 744/1948 (38.2%), "Put it off" 343/1948 (17.6%), "Didn't need it" 331/1948 (16.9%), "Doctor didn't order it" 162/1948 (8.3%), and "I'm too young" 63/1948 (5.3%). Multiple variable analyses demonstrated that lack of health insurance was the strongest predictor of mammography non-engagement (p< 0.001). Conclusion: Deficits in shared- decision-making in women younger than 50 years related to mammography utilization exist. Radiologists may be key in addressing this issue among ambulatory care providers and patients, educating about the benefits and harms of screening younger women, particularly in racial/ethnic minorities and uninsured patients, who experience additional barriers to care and SDM discussions. (Copyright © 2022 The Association of University Radiologists. Published by Elsevier Inc. All rights reserved.)
Databáze:	MEDLINE
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