FACTORS ASSOCIATED WITH MAMMOGRAPHY UTILIZATION IN UNDERSERVED WOMEN IN SOUTH DALLAS, TX

Purpose: To explore the association between self-reported mammography history, demographic characteristics, and medical care services. Methods: 430 women, aged 40 years and older, recruited between 2010 and 2012 for a breast cancer prevention program, were surveyed at baseline. Surveys were paper questionnaires administered with help from lay health educators. We tested the association between previous mammogram history of the participants and demographic characteristics, as well as medical care characteristics using chi-square tests and a multivariable logistic regression. Variable selection into the model was performed with a stepwise method. Results: In the univariate analysis, results from the chi-square test indicated that four demographic variables were significantly associated (P < 0.05) with having ever received a mammogram: age, race, family income, and marital status. Seven medical care variables were significantly associated with having ever received a mammogram: (1) health insurance, (2) ever performed a breast self-examination in the last month, (3) ever had a clinical breast examination in the previous year, (4) having a personal doctor, (5) regular check-ups, (6) ever talked to a doctor about breast cancer, and (7) talking to a doctor about receiving a mammogram. In the multivariable logistic analysis, age, marital status, insurance, and talking to doctor on mammogram remained significant: 65-74 years old vs. 40-49 years old (OR = 10.9, 95% CI: 1.4-85.0), 50-64 years old vs. 40-49 years old (OR=1.8, 95%C: 1.1-2.9), ever married vs. never married (OR = 1.8, 95% CI: 1.1-3.1), having health insurance vs. not (OR = 1.8, 95% CI: 1.1-3.0), and having ever talked to a doctor about receiving a mammogram vs. not (OR = 3.2, 95% CI: 1.9-5.2). Conclusions: Being older, married, having health insurance, and ever talked to a doctor about receiving a mammogram were positively associated with past mammography. On the other hand, there is a need to develop specific strategies for promoting mammography among younger, unmarried, or underinsured women. Further study needs to be conducted in a more racially-diverse population to support these findings.