Abstract PO-240: The effect of emotional disorders on adherence to mammography screening guidelines
Authors: Yazgan Idil , Chagpar Anees 
Published: December 2020

Abstract
INTRODUCTION: Approximately 18 million adults in the US experience a major depressive episode and 48 million report having some anxiety disorder each year. While some studies have found having an emotional disorder to be correlated with lower rates of screening mammography, this is not a consistent finding. We sought to determine whether women who felt limited by such disorders had lower mammography guideline compliance rates compared to women who did not, in a population-based study. METHODS: The National Health Interview Survey is a population-based survey administered annually by the Centers for Disease Control and is designed to be representative of the entire US civilian non-institutionalized population. We defined “emotional disorders” (EMD) as occurring in individuals who felt that they were limited in some way by depression, anxiety or another emotional problem. Women between the ages of 50 and 74, with and without EMD, were compared in terms of their adherence to screening guidelines, defined as having had a mammogram within the past two years, controlling for sociodemographic factors. RESULTS: In 2018, of the 5815 women surveyed who met our inclusion criteria (representing 48,522,391 women in the population), 3.25% stated that they were limited in some way by emotional issues. Of these, 68.28% stated they had a mammogram within the past two years; compared to 79.36% of women without EMD (p=0.002). Compared to those with no EMD, women with EMD tended to have lower education levels (less than grade 12: 19.51% vs 11.22%, p&lt;0.001), lower family income (above four times the poverty threshold: 15.31% vs 44.74%, p&lt;0.001) and less private insurance coverage (16.48% vs 55.93%, p&lt;0.001). However, those with EMD were more likely to report having a usual place to go when sick than those without EMD (90.65% vs. 86.23%, p=0.003). Compliance with mammography screening was similarly influenced by these factors (p&lt;0.001 for all). Controlling for these potential confounders, we found that EMD was no longer a significant predictor of mammography screening adherence (OR=0.77; 95% CI: 0.48-1.22, p=0.131). Rather, having a family income four times the poverty line or greater (OR=1.75; 95% CI: 1.29-2.37, p=0.001), having a usual place of healthcare (OR=2.67; 95% CI: 1.92-3.71, p&lt;0.001), and insurance coverage (OR=1.65; 95% CI: 1.17-2.35, p=0.005 for governmental insurance, and OR=1.74; 95% CI: 1.21-2.51, p=0.003 for private insurance, vs. uninsured) were significant independent predictors of adherence to screening mammography guidelines. CONCLUSION: While EMD is correlated with lower mammography screening rates, adherence to screening mammography guidelines are driven primarily by socioeconomic factors such as income, insurance status, and access to healthcare. There is a need for policy level changes that target these modifiable issues for those who are medically underserved, including those with EMD who are more likely to have a family income that is below the poverty line.
Citation Format: Idil Yazgan, Anees Chagpar. The effect of emotional disorders on adherence to mammography screening guidelines [abstract]. In: Proceedings of the AACR Virtual Conference: Thirteenth AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2020 Oct 2-4. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2020;29(12 Suppl):Abstract nr PO-240.