Knowledge, Attitudes, and Behavior of Women Ages 65 and Older on Mammography Screening and Medicare: Results of a National Survey

• Published in: Women & health 2002-01, Vol.36 (4), p.1-18
• Main Authors: Eisner, Ellen J., Zook, Eric G., Goodman, Nina, Macario, Everly
• Format: Article
• Language: English
• Subjects: Aged; Aged, 80 and over; Aging; Attitudes; Behavior; Breast cancer; Breast Neoplasms - diagnostic imaging; Breasts; Disease; Female; Health; Health Care Surveys; Health conditions; Health Knowledge, Attitudes, Practice; Humans; Illnesses; Life; Lifetime; Mammography; Mammography - economics; Mammography - utilization; Mass Screening - economics; Mass Screening - utilization; Medical screening; Medicare; Medicare - utilization; Minority Groups; National Institutes of Health (U.S.); Older people; older women; Patient Acceptance of Health Care - ethnology; Prevention; Preventive medicine; Public health education; Risk Factors; Screening mammograms; Socioeconomic Factors; United States; Women
• ISSN: 0363-0242; 1541-0331
• DOI: 10.1300/J013v36n04_01

Background: Compared to younger women, women 65+ will experience the greatest increase in new breast cancer cases. In 1991, Medicare began offering partial reimbursement for screening mammography every 2 years. Methods: In 1999, the National Cancer Institute (NCI) conducted a telephone survey on breast cancer, mammography, and Medicare reimbursement with a sample of households containing women ages 65+ using random-digit-dialing. Results were weighted to provide nationally representative estimates of U.S. women 65+. NCI compared 1999 results with similar data from a 1992 AARP survey. Results: Of the 814 women surveyed, 88% had had at least one mammogram in their lifetime; within this group, 80% had received their most recent mammogram 2 years ago or less. Only 57%, however, knew about recommendations to have a mammogram every 1-2 years. Approximately one-third indicated that they were not as concerned about getting breast cancer as when they were younger, and/or that women without risk factors could be less vigilant about mammograms. More than 75% were aware of Medicare coverage, but only 58% had used Medicare to help pay for their last mammogram. Minority women were almost twice as likely to be unaware of Medicare coverage. Recommendations: (1) Highlight that breast cancer risk increases with age (and does not decline in the absence of risk factors) and communicate the correct frequency for having mammograms; (2) expand primary care physicians' roles in promoting mammography screening for women 65+; and (3) provide Medicare coverage information to older women, particularly those not taking advantage of this benefit.