THE RISK-FACTORS OF AGE AND FAMILY HISTORY AND THEIR RELATIONSHIP TO SCREENING MAMMOGRAPHY UTILIZATION

Objective: To study the association of two well known risk factors for breast cancer and the association of knowledge of those risk factors with mammography utilization. Design: Cross sectional: two independent random telephone surveys. Setting: Two Northeastern metropolitan communities surveyed in 1987 and in 1989. Participants: Women without breast cancer who spoke English and who were between 45 and 75 years of age. Main Outcome Measures: The two risk factors measured were a family history of breast cancer and being 65 or older. Participants were surveyed about their knowledge of risk factors, presence of risk factors, selected beliefs, attitudes, reinforcing factors and mammography use. Results were analyzed for women 50-75. Results: There was a substantial increase in mammography use over the 2-year period. Having a positive family history or being older is not associated with increased mammography utilization. Knowledge that family history and/or age are risks is associated with increased utilization. However, knowledge of risk factors is not associated with having those risks. Older women have lower utilization than younger women regardless of their knowledge of age as a risk. Increased physician recommendation is associated with increased utilization. Conclusion: Since knowing that a factor is a risk and having a physician recommend mammography are each associated with increased use, we conclude that the primary care physicians' role in increasing mammography utilization is critical.