Breast cancer screening for older women in a primary care practice

• Published in: Journal of the American Geriatrics Society (JAGS) Vol. 48; no. 8; p. 961
• Main Authors: Tishler, J, McCarthy, E P, Rind, D M, Hamel, M B
• Format: Journal Article
• Language: English
• Published: United States 01.08.2000
• Subjects: Academic Medical Centers; Activities of Daily Living; Aged; Aged, 80 and over; Boston; Breast Neoplasms - diagnosis; Comorbidity; Female; Humans; Internal Medicine - methods; Internal Medicine - statistics & numerical data; Male; Mammography - statistics & numerical data; Mass Screening - methods; Mass Screening - statistics & numerical data; Palpation - statistics & numerical data; Practice Patterns, Physicians' - statistics & numerical data; Primary Health Care - methods; Primary Health Care - statistics & numerical data; Retrospective Studies; Sex Factors
• ISSN: 0002-8614; 1532-5415
• DOI: 10.1111/j.1532-5415.2000.tb06895.x

To determine rates of breast cancer screening for older women cared for in a primary care practice and to identify associations between patient and physician characteristics and breast cancer screening. A retrospective cohort study of older women. An urban hospital-based academic general medicine practice. This practice uses a computerized medical record and office procedures that facilitate tracking and ordering of mammograms. A random sample of 130 women aged 65 to 80 who receive primary care at a hospital-based general medicine practice. Data were collected from the hospital's computerized medical record. We recorded all clinical breast exams and mammograms performed or recommended during the 2-year study period. The median age of the 130 women studied was 71, and 21% of the women were black. Most patients had no serious comorbid illness (69%) and were independent in their activities of daily living (92%). During the 2-year study period, mammography was recommended for 95% of women and completed for 84%, and clinical breast exam was performed on 75%. Patients of male physicians had higher rates of mammography than patients of female physicians (89% vs. 75%, P = .045). Patients of faculty physicians had higher rates of clinical breast exam than patients of house officers or fellows (83% vs. 56%, P = .001). We report a very high rate of mammography for women cared for at a hospital-based primary care practice. The systems in place to facilitate ordering and tracking of mammograms probably contributed to the unusually high rate of mammography observed.