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Decrease in hormone therapy use associated with mammography rate decrease in younger women
Breen N. Cancer. 2011;doi:10.1002/cncr.26218.
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The simultaneous decrease in hormone therapy use and mammography screenings in 2005 appears to be related in women aged 50 to 64 years but not in women aged older than 65 years, according to researchers who evaluated the National Health Interview Survey data.
Using multivariate logistic regression, the researchers tested for an interaction between hormone therapy use and survey year while controlling for a range of factors in data from 2000 and 2005. They found that hormone therapy use decreased from 41% to 16% among women aged 50 to 64 years and from 19% to 10% among women aged at least 65 years. Biennial mammography rates decreased from 78% to 73% among the 50- to 64-year-old age group and from 67% to 65% among women aged at least 65 years.
In the 50- to 64-year-old age group, the researchers reported that women who stopped hormone therapy had lower screening rates after they stopped therapy than while taking hormone therapy. Among women aged at least 65 years, researchers found that women who were current users of hormone therapy had lower rates of mammography in 2005 compared with 2000, but nonusers had similar mammography rates in 2000 and 2005.
The researchers also reported predictors for reporting a recent mammogram: more education; a usual source of care; any race but non-Hispanic Asian; talking with an obstetrician or gynecologist within the past year; or current hormone therapy use. They also found that private health insurance was a predictor in the 50- to 64-year-old age group, and that younger age (65 to 74 years), having Medicare Part B or other supplemental Medicare insurance and “excellent” health were predictors for women aged at least 65 years.
“Our findings are significant and important in understanding the relation between hormone therapy and mammography use and the impact of mammography on mortality,” the researchers wrote. “An opportunistic system of screening leaves it to individual women to assess information in making a decision about the importance of having a mammogram relative to her resources. Therefore, different communication channels, because they reach women with different educational levels, may lead to different behaviors.”
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