HEALTH-STATUS AND MAMMOGRAPHY USE AMONG OLDER WOMEN

OBJECTIVE: To assess the extent to which an age-associated reduction i n mammography use can be explained by declining self-reported health s tatus. DESIGN: We analyzed data from the 1992 National Health Intervie w Survey (NHIS) and Cancer Control Supplement. Logistic regression ana lysis was used to evaluate the association between age, health status (self-reported health and limitations in major activity), and other va riables potentially related to mammography use within the past 1 year (recent mammography). PARTICIPANTS: Of 12,035 NHIS respondents we rest ricted our analysis to the 1,772 women aged 50 years or older who repo rted one or more lifetime mammograms. We excluded women without a mamm ogram (n = 937) because we were interested in factors related to recen t use versus past use of mammography. MEASUREMENTS AND MAIN RESULTS: T he percentage of women with a recent mammogram declined with increasin g age, and the age association was independent of other factors includ ing health status (adjusted odds ratio [OR] comparing women aged 75 ye ars or older with those aged 50 to 64 years was 0.54; 95% confidence i nterval [CI] 0.41, 0.70). This age effect persisted in an analysis res tricted to women reporting good or better health (adjusted OR was 0.SO , 95% CI 0.44, 0.80). CONCLUSION: The observed decline in recent mammo graphy use with advancing age was not explained by variation in health status. Because healthy elderly women may live long enough to realize the potential benefit of screening mammography, factors responsible f or its reduced use should be identified. Doing so will allow for the s elective promotion of screening mammography among those older women mo st likely to benefit.