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The association between visiting a primary care provider and the uptake of periodic mammograms as women get older

Sutradhar R, Gu S, Glazier RH, Paszat LF; Ontario Cancer Screening Research Network. J Med Screen. 2016; 23(2):83-8. Epub 2015 Sep 9.

Objective — To determine whether visits to a primary care provider (PCP) are associated with the uptake of periodic mammograms as women get older.

Methods — The cohort consisted of female residents from Ontario, Canada, who were age 50 to 79 at any point from January 1st, 2001 to December 31st, 2010. All women had to be cancer-free and eligible for the Ontario Health Insurance Plan prior to study entry. A non-parametric estimation approach was used to describe the mean cumulative number of periodic mammograms for women, with and without recent exposure to a PCP, as a function of age. Using age as the time scale, a recurrent event regression model was also implemented to examine the association between exposure to a primary care provider and rate of periodic mammograms, adjusted for income quintile and comorbidity.

Results — The cohort consisted of 2,389,889 women with a mean observation window of 7.0 years. The uptake of periodic mammograms was significantly higher for women with recent exposure to a PCP compared to women without recent exposure to a PCP. This trend remained consistent as women aged, and the magnitude of the association increased for women 65 years or older. Moreover, the relative rate of periodic mammograms was lower than 1 and consistently decreased as we compared women from the lower income quintiles against women from the wealthiest income quintile.

Conclusion — Visits to a primary care provider play an important role in a women’s uptake of periodic mammograms, and this association increases as women get older.

Keywords: Breast cancer Screening and prevention Primary care/clinical practice