A comparison of breast cancer secondary prevention activities and satisfaction with access and communication issues in women 50 and over

Background, Between 1950 and 1990, the incidence of breast cancer increased about 52% and the mortality rate increased 4%. Prevention programs (mammog rams and clinical breast exams) can positively affect both cost control and mortality rates. Balancing the costs of preventive screening against the p otential savings is a part of an ongoing debate centering on the age at whi ch women should have yearly mammograms. Yet, if all agencies agree that wom en aged 50 and over should receive yearly mammograms, then why are so many women aged 50 and over not being screened? Methods. Using previously validated instruments, this study surveyed reside nts of Spokane County, Washington. Respondents (1,850 returned of 2,600) we re compared over time by demographic characteristics and by insurance type to identify any significant differences between those who had preventative screens and those who did not. Issues involving access to screening and com munication with healthcare providers were also examined. Results. Factors that affect whether women receive preventative screening i nclude insurance type, provider type, long waiting times, and poor communic ation among the doctor, the staff, and the patient. Conclusion. The most important determinant to whether preventative screenin g is being conducted is the relationship between the patient and their heal thcare provider. (C) 2001 American Health Foundation and Academic Press.