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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 (mammograms and clinical breast exams) can positively affect both cost control and mortality rates. Balancing the costs of preventive screening against the potential savings is a part of an ongoing debate centering on the age at which women should have yearly mammograms. Yet, if all agencies agree that women 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 residents of Spokane County, Washington. Respondents (1,850 returned of 2,600) were 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 communication with healthcare providers were also examined.


RESULTS
Factors that affect whether women receive preventative screening include insurance type, provider type, long waiting times, and poor communication among the doctor, the staff, and the patient.


CONCLUSION
The most important determinant to whether preventative screening is being conducted is the relationship between the patient and their healthcare provider.