Health Insurance and Other Factors Associated With Mammography Surveillance Among Breast Cancer Survivors

Results From a National Survey

Dados Bibliográficos

ID9101904
AutoresSusan A Sabatino (Centers for Disease Control and Prevention), Trevor D Thompson, Trevor Thompson (0009-0005-0226-395X, Centers for Disease Control and Prevention), Lisa C Richardson (0000-0002-9555-7674, Centers for Disease Control and Prevention), Jacqueline Miller (0000-0002-6474-0505, Centers for Disease Control and Prevention)
Ano2012
Volume50
Fascículo3
Páginas270-276
Data de publicação2012-03-01
Peer ReviewedSim
Open AccessNão
TipoARTICLE
PeriódicoMedical Care (JOURNAL)
Identificadores do periódicoISSN: 0025-7079 • E-ISSN: 1537-1948
EditoraOvid Technologies (Wolters Kluwer Health) (PUBLISHER)
DOI10.1097/mlr.0b013e318244d294
PMID22193416
OpenAlexW2062827229
IdiomaEN
Citações recebidas4
Referências citadas35

BACKGROUND: Whether disparities in mammography surveillance among breast cancer survivors exist by health insurance type is unclear. OBJECTIVES: To determine the association of surveillance mammography with insurance and other factors among breast cancer survivors. DESIGN/PARTICIPANTS/MEASURES: We examined mammography within the prior year among 1511 breast cancer survivors aged 30 or older and ≥1 year after diagnosis from the 2000, 2003, 2005, and 2008 National Health Interview Surveys. Insurance included private (health maintenance organization/independent practice association, other, unspecified), Medicare+private, public only (Medicare+Medicaid, other Medicare, other public), and uninsured. Multivariable logistic regression was used to determine factors associated with mammography, including age, race/ethnicity, education, time since diagnosis, health status, insurance, income to poverty threshold ratios, having a usual provider, and survey year. Results are presented as predictive margins. For insurance, pairwise comparisons were used to compare Medicare+private versus other groups. RESULTS: Overall 75% reported a mammogram. Mammography reporting was lower for uninsured survivors and those with only public insurance versus Medicare+private or private (50% and 68% vs. 76% and 80%, respectively; P=0.001). In each insurance group, 20% to 50% reported not receiving a mammogram. After adjustment, use remained lower for women with only public insurance versus Medicare+private (71% vs. 78%, P=0.029). Age of at least 75 years, greater time since diagnosis, and no usual provider were associated with not reporting a mammogram. CONCLUSIONS: One in 4 breast cancer survivors did not report guideline-concordant mammography surveillance. Women with only public insurance were less likely than those with Medicare+private coverage to report a mammogram. Efforts to understand barriers and promote mammography among survivors are needed

Breast cancer · Breast cancer screening · Cancer · Family medicine · Health care · Logistic regression · Mammography · Medicaid · Public health · Cancer survivorship and care · Demography · Digital Radiography and Breast Imaging · Global Cancer Incidence and Screening · Internal Medicine · Medicine · Nursing