INITIAL AND REPEAT MAMMOGRAPHY SCREENING IN A LOW-INCOME MULTIETHNIC POPULATION IN LOS-ANGELES

Low income, older, minority women are at high risk for underutilizatio n of screening mammography. One strategy for increasing utilization is to conduct interventions targeting local and state health departments where a majority of these women seek health care. A prerequisite for conducting effective screening programs is to obtain current and accur ate information on baseline screening rates to understand the nature a nd scope of the problem and to plan appropriate intervention strategie s. The sample consisted of 3240 women who were 50+ years of age from 2 hospitals and 2 comprehensive health centers operated by the Los Ange les County Department of Health Services. Reviews of medical records i ndicated that only 21% of the sample had received a mammogram in the 1 2 months prior to the clinic visit on which they were sampled and 23% of the sample received a mammogram in the following 9 months. Approxim ately 5% of the ; total sample received a repeat mammogram in the 21-m onth period over which they were tracked. Prospective independent pred ictors of screening were age, number of visits to primary care clinics , number of visits to specialty care clinics, and history of breast ab normalities. The results underscore the importance of implementing pro grams to increase mammography screening within public facilities servi ng low income multiethnic women. An important finding is that a large number of older women are seen in specialty clinics, which represents an untapped resource for increasing screening in this population. Inno vative interventions targeting such specialty clinics could substantia lly contribute to increasing screening rates. A comprehensive approach targeting system, physician, and patient barriers is recommended.