Abstract B62: The impact of family structure on mammography utilization.
Authors: Holmes Katelyn Ruth 
Published: August 2014

Introduction: Screening mammography is universally recognized as the most effective screening tool for breast cancer. The current study examines the impact of family structure on regular mammography utilization. First, it evaluates whether the presence of dependent children in a household affect a woman's mammography behaviors. The analyses empirically identify the magnitude and the direction of any systematic differences in screening between women who do and do not have dependent children at home, and factors associated with receipt of screening in these populations. The study then examines whether the presence of a partner in the home modifies the relationship between dependent children and mammography utilization.

Methods: The sample for the study consists of a subsample of the participants in the National Health Interview Survey (NHIS) in 2010. Data collection for NHIS follows a cross-section design with households as the unit of analysis. In 2010, 27,000 individuals answered questions on cancer screening behaviors. Of the participants, 8,968 women over the age of 40 answered questions on breast cancer screening behaviors. The NHIS also contains individual demographic information including age, education, income, race, and ethnicity, as well as household demographic information.

A logistic regression model evaluated the impact of family structure on a woman's probability of regular mammography utilization. A second model examined the interactions between predictor variables.

Results: The presence of a partner in the household significantly predicts mammography use. Women with a partner in the home have odds that are 17% higher than the odds for their single counterparts of reporting receiving mammography. The result is statistically significant at the 0.01 level.

Age significantly predicts mammography utilization. Women ages 50-64 years have odds of recommended mammography receipt that are 57% higher than the odds for women ages 40-49 years.

Despite the significant findings for age and the presence of a partner, the presence of dependent children in the household did not significantly impact rates of mammography.

The interaction term for middle age and dependent children in the household, as well as the interaction term for having dependent children and a partner in the household, was not significant. However, when compared to younger women without dependent children in the household, women over 65 years old with dependent children in the household were significantly less likely to receive mammography according to screening recommendations.

Conclusion: While age, education, household income, and the presence of a partner in the household significantly predicted mammography utilization, women with children in the household did not utilize mammography at statistically different rates than women residing in households without dependent children. However, for women ages 65 and older, dependent children residing in the household significantly negatively predicted the receipt of a mammogram.

The hypothesized relationship of caregiving demands for dependent children competing with breast cancer screening was not supported by the findings of logistic regression analysis, but caregiving demands for women ages 65 and older may help to explain the finding of an interaction between older age and dependent children in the household.

Citation Format: Katelyn Ruth Holmes. The impact of family structure on mammography utilization. [abstract]. In: Proceedings of the Fifth AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2012 Oct 27-30; San Diego, CA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2012;21(10 Suppl):Abstract nr B62.