Predictors of mammography use among Canadian women aged 50-69: findings from the 1996/97 National Population Health Survey

Background: Screening mammography, although recommended every 2 years for w omen aged 50-69, is thought to be underused among select groups of Canadian women. Methods: We used data from the 1996/97 National Population Health Survey to describe current patterns in mammography use (including reasons for not ha ving a mammogram within the 2 years before the survey and future screening intentions) in Canada and to determine factors associated with nonparticipa tion and time-inappropriate use (mammogram 2 or more years before the surve y) among women aged 50-69. Results: Among respondents aged 50-69, 79.1% (95% confidence interval [CI] 76.9%-81.2%) reported ever having had a mammogram, and 53.6% (95% CI 51.4%- 55.9%) had had a recent (time-appropriate) mammogram (within the 2 years be fore the survey). Only 0.6% (95% CI 0.3%-0.9%) of recently screened women r eported problems of access, and few reported personal or health system barr iers as reasons for not obtaining a recent mammogram. Over 50% of the women who had not had a recent mammogram reported that they did not think it was necessary, and only 28.2% (95% CI 23.8%-32.7%) of those who had never had a mammogram planned to have one within the 2 years following the survey. Th e rate of time-appropriate mammography varied significantly by province, fr om 41.1% (95% CI 29.3%-52.9%) in Newfoundland to 69.4% (95% CI 61.3%-77.6%) in British Columbia. Significant predictors of never having had a mammogra m included higher age, residence in a rural area, Asia as place of birth, n o involvement in volunteer groups, no regular physician or recent medical c onsultations (including recent blood pressure check), current smoking, infr equent physical activity and no hormone replacement therapy. Interpretation: Despite increases in mammography screening rates since the 1994/95 National Population Health Survey, current estimates indicate that almost 50% of women aged 50-69 have not had a time-appropriate mammogram. O ur findings confirm continued low mammography participation rates among old er women and those in rural areas, select ethnic groups and women with nega tive health care and lifestyle characteristics.