The Open Clinical Cancer Journal




(Discontinued)

ISSN: 1874-1894 ― Volume 5, 2011

What Factors are Associated with Where Women Undergo Clinical Breast Examination? Results from the 2005 National Health Interview Survey



Steven S. Coughlin* , Susan A. Sabatino , Kate M. Shaw
Division of Cancer Prevention and Control, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Atlanta, GA, USA

Abstract

Background:

Recent studies have suggested that clinical breast examination (CBE) rates may vary according to patient, provider and health care system characteristics.

Objective:

To examine the locations where U.S. women received a CBE and other general preventive health, and to examine predictors of location of receipt of general preventive health care (including a recent CBE).

Design:

Age-specific and age-adjusted rates of CBE use were calculated using Statistical Analysis Software (SAS) and SUDAAN. A multivariate analysis was carried out using logistic regression techniques.

Participants:

Women aged 40 years and older (n = 10,002) who participated in the 2005 National Health Interview Survey (NHIS).

Measurements:

Recent CBE use was defined as within the past two years.

Results:

Among all women, 65% reported a CBE within two years. The highest rate was found among women receiving routine care from doctors’ offices and health maintenance organizations (HMOs) (68.5%). CBE use was somewhat lower among women receiving routine care from clinics or health centers (62.9%), and substantially lower among women re- ceiving care from “other” locations (28.4%) or not reporting receiving preventive care (25.3%). Low income women (p < .01) and those with less than a high school education (p < .01) are more likely to go to a hospital than higher SES women. Women with health insurance are much more likely than women without health insurance to go to a doctor’s office or HMO, and less likely to be seen at a clinic or health center (p < .01 in both instances). In multivariate analysis, women who received routine care in a location other than a clinic or health center, doctor’s office or HMO, or hospital outpatient department (OPD) were less likely to have received a CBE within the past two years (adjusted OR = 0.4, 95% CI = 0.3, 0.7) compared to those at a doctor’s office or HMO.

Conclusions:

After adjusting for patient factors, clinics/health centers and hospital OPDs performed as well as doctors’ offices/HMOs in delivering CBE. However, women receiving care in other locations were less likely to report CBE

Keywords : Breast cancer, clinical breast examination, physicians, primary health care.

Article Information


Identifiers and Pagination:

Year: 2008
Volume: 2
First Page: 32
Last Page: 43
Publisher Id: TOCCJ-2-32
DOI: 10.2174/1874189400802010032

Article History:

Received Date: 3/4/2008
Revision Received Date: 11/4/2008
Acceptance Date: 6/6/2008
Electronic publication date: 25 /6/2008
Collection year: 2008

© Coughlin et al; Licensee Bentham Open.

open-access license: This is an open access article licensed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/ which permits unrestricted, non-commercial use, distribution and reproduction in any medium, provided the work is properly cited.


* Address correspondence to this author at the Epidemiology and Applied Research Branch, Division of Cancer Prevention and Control, Atlanta, GA 30341, USA; Tel: (770) 488-4776; Fax: (770) 488-4639; E-mail:sic9@cdc.gov


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