Abstract 2583: Mammography decision-making: Trends, predictors and effects of provider communication in the Health Information National Trends Survey 2011-2015
Authors: Spring Laura , Marshall Megan R. , Warner Erica T. 
Published: July 2016

Introduction: In 2009 the US Preventive Services Task Force (USPSTF) recommended against routine annual mammograms among women aged 40-49. However, mammography utilization appears unchanged since that time. We examined whether women, particularly those ages 40-49, are having discussions about mammography with their healthcare providers and how this affects screening behavior.

Methods: Data were drawn from the 2011-2014 Health Information National Trends Survey (HINTS). We included female respondents age 40 or older with no personal history of breast cancer who reported a medical visit in the previous two years, and responded to the following question: ‘Has a doctor or other health professional ever told you that you could choose whether or not to have a mammogram?’ (N = 5085). We examined trends in the proportion of women reporting provider communication on mammogram choice according to 10-year age group. We used logistic regression to generate odds ratios (OR) and 95% confidence intervals (CI) for predictors of provider communication and also assessed whether provider communication was associated with mammography screening in the previous two years.

Results: Less than half of the women reported provider communication on mammogram choice in each year (2011:44.3%; 2012: 37.5%; 2013: 37.0%; 2014: 43.6%). In every year except 2014, women age 40-49 were most likely to report provider communication, though this difference was only significant in 2013 (45% vs. 30.2-36.6%; p = 0.02). In multivariable-adjusted models, women age 40-49 were 27% more likely to report provider communication on mammogram choice (OR: 1.27, 95% CI: 1.02-1.59) compared to women age 50-59. Non-Hispanic black women were 33% less likely to report such communication (OR: 0.67, 95% CI: 0.52-0.88) compared to non-Hispanic Whites. The youngest (40-49 years) and oldest (≥70 years) women were most likely to report no mammogram in the previous two years. Women who reported provider communication on mammogram choice were 17% more likely to report no mammogram in the past two years (OR: 1.17, 95% CI: 0.93-1.46), though this was not statistically significant. When stratified by 10-year age group, provider communication was only associated with higher risk of no mammogram among women age 70 and older (OR: 1.93, 95% CI: 1.29-2.89).

Conclusions: Between 2011-2014 women age 40-49 were the most likely to receive healthcare provider communication on mammogram choice. Still, the majority of women in that age group did not receive such communication despite the 2009 USPSTF recommendation that the decision to start screening mammography prior to age 50 should be an individualized one that takes into account patient values regarding specific benefits and harms. Provider communication on mammogram choice can influence screening behavior, particularly for older women.

Citation Format: Laura Spring, Megan R. Marshall, Erica T. Warner. Mammography decision-making: Trends, predictors and effects of provider communication in the Health Information National Trends Survey 2011-2015. [abstract]. In: Proceedings of the 107th Annual Meeting of the American Association for Cancer Research; 2016 Apr 16-20; New Orleans, LA. Philadelphia (PA): AACR; Cancer Res 2016;76(14 Suppl):Abstract nr 2583.