Table 3.
Hazard ratios (HRs), 95% confidence intervals (CIs), and p-values for time to non-adherence to screening mammography guidelines from multivariable Cox proportional hazards model, by participant and community characteristics, estimated in the Breast Cancer Surveillance Consortium-Medicare cohort receiving an index screening mammogram between January 1, 2005 and July 1, 2008.
Age 66–70 at index | Age 71–75 at index | |||||||
---|---|---|---|---|---|---|---|---|
95% CI | 95% CI | |||||||
Characteristic at the index mammogram | HR of non-adherence | lower bound | upper bound | p | HR of non-adherence | lower bound | upper bound | p |
Demographics | ||||||||
Age, years | ||||||||
66 | 1 (ref) | 0.03 | ||||||
67 | 1.18 | 0.97 | 1.43 | |||||
68 | 1.26 | 1.04 | 1.53 | |||||
69 | 1.27 | 1.04 | 1.54 | |||||
70 | 1.33 | 1.10 | 1.61 | |||||
71 | 1 (ref) | 0.05 | ||||||
72 | 1.04 | 0.86 | 1.27 | |||||
73 | 1.04 | 0.86 | 1.27 | |||||
74 | 1.14 | 0.94 | 1.39 | |||||
75 | 1.31 | 1.08 | 1.59 | |||||
Race/ethnicity | ||||||||
White | 1 (ref) | 0.76 | 1 (ref) | 0.57 | ||||
Black | 1.02 | 0.73 | 1.44 | 1.01 | 0.70 | 1.45 | ||
Asian/Pacific Islander | 1.44 | 0.85 | 2.45 | 0.81 | 0.42 | 1.56 | ||
Hispanic | 0.98 | 0.55 | 1.74 | 0.77 | 0.41 | 1.44 | ||
Other/unknown | 1.03 | 0.79 | 1.35 | 0.83 | 0.63 | 1.09 | ||
Education | ||||||||
<HS graduate | 1.41 | 1.11 | 1.80 | 0.03 | 1.55 | 1.24 | 1.93 | 0.001 |
HS graduate or GED | 1.17 | 0.99 | 1.38 | 1.21 | 1.02 | 1.43 | ||
Some college or technical school | 1.19 | 1.01 | 1.42 | 1.06 | 0.88 | 1.27 | ||
College graduate | 1 (ref) | 1 (ref) | ||||||
Community characteristics | ||||||||
Census tract diversity index | ||||||||
<8.1 | 1 (ref) | 0.24 | 1 (ref) | 0.02 | ||||
8.1–18.8 | 0.87 | 0.73 | 1.03 | 0.77 | 0.65 | 0.92 | ||
18.8–45.9 | 0.82 | 0.66 | 1.01 | 0.78 | 0.63 | 0.96 | ||
>45.9 | 0.81 | 0.62 | 1.05 | 0.81 | 0.63 | 1.06 | ||
Proportion linguistically isolated | ||||||||
None | 1 (ref) | 0.78 | 1 (ref) | 0.86 | ||||
Any (>0) | 0.94 | 0.59 | 1.48 | 1.04 | 0.66 | 1.64 | ||
Median household income | ||||||||
<$43,827 | 1 (ref) | 0.02 | 1 (ref) | 0.16 | ||||
$43,827-$55,386 | 1.09 | 0.90 | 1.30 | 1.07 | 0.90 | 1.28 | ||
$55,386-$75,553 | 1.07 | 0.84 | 1.37 | 0.94 | 0.73 | 1.20 | ||
>$75,553 | 0.73 | 0.53 | 1.01 | 1.21 | 0.88 | 1.67 | ||
Average public transportation expenditures | ||||||||
<$20 | 1 (ref) | 0.09 | 1 (ref) | 0.05 | ||||
$20-$28 | 0.83 | 0.67 | 1.02 | 0.99 | 0.81 | 1.21 | ||
$28-$44 | 0.92 | 0.72 | 1.19 | 1.04 | 0.82 | 1.34 | ||
>$44 | 1.12 | 0.79 | 1.58 | 0.71 | 0.50 | 1.02 | ||
Proportion with college degree | ||||||||
<19% | 1 (ref) | 0.33 | 1 (ref) | 0.35 | ||||
19%–32% | 0.97 | 0.81 | 1.17 | 0.93 | 0.77 | 1.11 | ||
32%–49% | 1.17 | 0.92 | 1.48 | 0.82 | 0.65 | 1.05 | ||
>49% | 1.05 | 0.77 | 1.43 | 0.95 | 0.70 | 1.29 | ||
Proportion with access to internet | ||||||||
<81% | 1 (ref) | 0.18 | 1 (ref) | 0.78 | ||||
81%–84% | 0.96 | 0.73 | 1.27 | 1.03 | 0.78 | 1.36 | ||
84%–93% | 0.79 | 0.59 | 1.06 | 0.89 | 0.66 | 1.18 | ||
>93% | 1.06 | 0.74 | 1.52 | 0.92 | 0.64 | 1.32 | ||
Proportion read health magazines | ||||||||
<13% | 1 (ref) | 0.61 | 1 (ref) | 0.15 | ||||
13%–15% | 0.90 | 0.74 | 1.11 | 0.79 | 0.64 | 0.97 | ||
15%–16% | 0.89 | 0.71 | 1.10 | 0.87 | 0.70 | 1.09 | ||
>16% | 0.97 | 0.74 | 1.28 | 0.77 | 0.58 | 1.03 | ||
Proportion read newspaper daily | ||||||||
<41% | 1 (ref) | 0.11 | 1 (ref) | 0.82 | ||||
41%–46% | 0.94 | 0.73 | 1.21 | 1.05 | 0.81 | 1.35 | ||
46%–51% | 1.10 | 0.84 | 1.44 | 1.14 | 0.87 | 1.50 | ||
>51% | 0.82 | 0.61 | 1.09 | 1.10 | 0.82 | 1.47 | ||
Breast cancer risk factors | ||||||||
Family history of breast cancer | ||||||||
Yes | 1.04 | 0.86 | 1.26 | 0.71 | 0.88 | 0.72 | 1.07 | 0.21 |
No | 1 (ref) | 1 (ref) | ||||||
BCSC 5-year breast cancer risk | ||||||||
0 to <1% | 1.23 | 0.64 | 2.35 | 0.12 | 0.76 | 0.34 | 1.70 | 0.007 |
1 to 1.66% | 1.22 | 0.99 | 1.50 | 1.17 | 0.95 | 1.44 | ||
1.67 to 2.49% | 1 (ref) | 1 (ref) | ||||||
>=2.5% | 0.91 | 0.78 | 1.06 | 0.81 | 0.70 | 0.95 | ||
Co-morbidity and healthcare utilization | ||||||||
Charlson co-morbidity score | ||||||||
≥1 | 1.44 | 1.24 | 1.66 | <0.001 | 1.32 | 1.15 | 1.52 | <0.001 |
0 | 1 (ref) | 1 (ref) | ||||||
Primary care visit in prior year | ||||||||
Yes | 1 (ref) | 0.14 | 1 (ref) | 0.95 | ||||
No | 1.16 | 0.96 | 1.41 | 0.99 | 0.81 | 1.22 | ||
Hospitalization in prior year | ||||||||
Yes | 1.31 | 1.08 | 1.59 | 0.008 | 1.04 | 0.86 | 1.26 | 0.69 |
No | 1 (ref) | 1 (ref) |
Boldface indicates statistical significance (p<0.05)