Skip to main content
PMC home page
American Journal of Public Health logoLink to American Journal of Public Health
. 1994 Jan;84(1):50–55. doi: 10.2105/ajph.84.1.50

Mammography screening: how important is cost as a barrier to use?

N Urban 1, G L Anderson 1, S Peacock 1
PMCID: PMC1614899  PMID: 8279611

Abstract

OBJECTIVES. Recent legislation will improve insurance coverage for screening mammography and effectively lower its cost to many women. Although cost has been cited as a barrier to use, evidence of the magnitude of its effect on use is limited. METHODS. Mammography use in the past 2 years among women aged 50 to 75 residing in four suburban or rural counties in Washington State was estimated from 1989 survey data. Logistic regression analysis was used to estimate the odds ratio of mammography use as a function of economic and other variables. Within a residential area, averages were used to measure the market price of mammography and the time cost to obtain a mammogram. RESULTS. Use was lower among women who faced a higher net price or who preferred to obtain a mammogram during weekend or evening hours and higher among women with higher incomes. Visiting no doctor regularly and smoking were predictors of failure to use mammography. CONCLUSION. The effects of economic variables on mammography use are important and stable across subsets of the population, but they are modest in size.

Full text

PDF

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Burack R. C., Liang J. The acceptance and completion of mammography by older black women. Am J Public Health. 1989 Jun;79(6):721–726. doi: 10.2105/ajph.79.6.721. [DOI] [PMC free article] [PubMed] [Google Scholar]
  2. Burg M. A., Lane D. S., Polednak A. P. Age group differences in the use of breast cancer screening tests. The effects of health care utilization and socioeconomic variables. J Aging Health. 1990 Nov;2(4):514–530. doi: 10.1177/089826439000200406. [DOI] [PubMed] [Google Scholar]
  3. Dionne G., Contandriopoulos A. P. Doctors and their workshops. A review article. J Health Econ. 1985 Mar;4(1):21–33. doi: 10.1016/0167-6296(85)90021-9. [DOI] [PubMed] [Google Scholar]
  4. Howard J. Using mammography for cancer control: an unrealized potential. CA Cancer J Clin. 1987 Jan-Feb;37(1):33–48. doi: 10.3322/canjclin.37.1.33. [DOI] [PubMed] [Google Scholar]
  5. Hurley S. F., Livingston P. M. Personal costs incurred by women attending a mammographic screening programme. Med J Aust. 1991 Jan 21;154(2):132–134. doi: 10.5694/j.1326-5377.1991.tb121001.x. [DOI] [PubMed] [Google Scholar]
  6. Johnson R. A., Murata P. J. Demographic, clinical, and financial factors relating to the completion rate of screening mammography. Cancer Detect Prev. 1988;11(3-6):259–266. [PubMed] [Google Scholar]
  7. Kessler L. G., Feuer E. J., Brown M. L. Projections of the breast cancer burden to U.S. women: 1990-2000. Prev Med. 1991 Jan;20(1):170–182. doi: 10.1016/0091-7435(91)90018-y. [DOI] [PubMed] [Google Scholar]
  8. King E. S., Rimer B. K., Trock B., Balshem A., Engstrom P. How valid are mammography self-reports? Am J Public Health. 1990 Nov;80(11):1386–1388. doi: 10.2105/ajph.80.11.1386. [DOI] [PMC free article] [PubMed] [Google Scholar]
  9. Kruse J., Phillips D. M. Factors influencing women's decision to undergo mammography. Obstet Gynecol. 1987 Nov;70(5):744–748. [PubMed] [Google Scholar]
  10. Lerman C., Rimer B., Trock B., Balshem A., Engstrom P. F. Factors associated with repeat adherence to breast cancer screening. Prev Med. 1990 May;19(3):279–290. doi: 10.1016/0091-7435(90)90028-i. [DOI] [PubMed] [Google Scholar]
  11. O'Leary T. J., deParedes E. S., Tritschler J., Barr M. Utilization of screening mammography by primary care physicians. Appl Radiol. 1989 Dec;18(12):28–33. [PubMed] [Google Scholar]
  12. Rimer B. K., Keintz M. K., Kessler H. B., Engstrom P. F., Rosan J. R. Why women resist screening mammography: patient-related barriers. Radiology. 1989 Jul;172(1):243–246. doi: 10.1148/radiology.172.1.2740510. [DOI] [PubMed] [Google Scholar]
  13. Shapiro S., Venet W., Strax P., Venet L., Roeser R. Ten- to fourteen-year effect of screening on breast cancer mortality. J Natl Cancer Inst. 1982 Aug;69(2):349–355. [PubMed] [Google Scholar]
  14. Taplin S. H., Thompson R. S., Schnitzer F., Anderman C., Immanuel V. Revisions in the risk-based Breast Cancer Screening Program at Group Health Cooperative. Cancer. 1990 Aug 15;66(4):812–818. doi: 10.1002/1097-0142(19900815)66:4<812::aid-cncr2820660436>3.0.co;2-1. [DOI] [PubMed] [Google Scholar]
  15. Thompson G. B., Kessler L. G., Boss L. P. Breast cancer screening legislation in the United States. Am J Public Health. 1989 Nov;79(11):1541–1543. doi: 10.2105/ajph.79.11.1541. [DOI] [PMC free article] [PubMed] [Google Scholar]
  16. Zapka J. G., Stoddard A. M., Costanza M. E., Greene H. L. Breast cancer screening by mammography: utilization and associated factors. Am J Public Health. 1989 Nov;79(11):1499–1502. doi: 10.2105/ajph.79.11.1499. [DOI] [PMC free article] [PubMed] [Google Scholar]

Articles from American Journal of Public Health are provided here courtesy of American Public Health Association

RESOURCES