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Changes in mammography use: economic, need, and service factors.

J G Zapka, D Hosmer, M E Costanza, D R Harris and A Stoddard

School of Public Health, University of Massachusetts, Amherst 01003.

OBJECTIVES. The purpose of this study was to document changes in mammography use between 1987 and 1990 and assess the relationship of use to selected economic, need, and health system factors. METHODS. Independent random-digit-dialed telephone surveys of women between 52 and 75 years of age were conducted. RESULTS. Between 1987 and 1990, the proportion of women who had had a mammogram in the past year increased from 31% to 51%. Though income was significantly related to overall patterns of use, it was not associated with recent mammogram use in 1990. Women with a family history of breast cancer reported greater use at both times, as did women who reported having a regular physician (particularly a gynecologist or internist). When all other variables were controlled for, women were over nine times more likely to have had multiple and recent mammograms in 1990 than in 1987. CONCLUSIONS. Mammography use dramatically increased between 1987 and 1990. There were strong relationships between the type of regular physician and mammography screening and between economic and personal history and repeated and recent mammography use.

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