Screening mammogram utilization in women with diabetes

OBJECTIVE - To determine whether women with diabetes undergo fewer screenin g mammograms than matched control subjects. RESEARCH DESIGN AND METHODS - A total of 424 women with diabetes aged 50-75 years who received their primary care from general internists at a large M idwestern multispecialty group practice were retrospectively studied for fr equency of mammography from August 1997 to January 2000. Two control subjec ts without diabetes (n = 845) were matched to each case by age, sex, provid er, and date of visit. The main outcome measure was the percentage of subje cts undergoing mammography 1 year before and 30 days after an index date, d efined as the most recent health care visit after August 1997 and before Ja nuary 2000. RESULTS - Analysis by conditional logistic regression demonstrated that wom en with diabetes had significantly lower rates of mammograms than control s ubjects (78.1 vs. 84.9%, respectively odds ratio 0.03, P = 0.002). After ad justing for insurance status and race, women with diabetes continued to hav e significantly lower rates of mammography (odds ratio 0.70, P = 0.027). CONCLUSIONS - Women with diabetes were significantly less likely to undergo screening mammography than control subjects. Considering the increasing in cidence of diabetes and the equal incidence of malignancy in women with and without diabetes, it would be beneficial to improve breast cancer screenin g in this population.