Provider factors influence breast cancer screening

Variations among women in breast cancer screening are due to provider and health system factors rather than patient characteristics, according to a study published online August 3 in the Journal of General Internal Medicine.

Because breast cancer screening uptake can be influenced by factors associated with patients, primary care providers, practices, and health systems, a team led by Tracy Onega, PhD, of Dartmouth College sought to clarify the effects of these factors on breast cancer screening.

The study consisted of a web-based survey distributed at 15 primary care practices that represented 306 providers and served 46,944 women. The survey covered patient visits between January 2011 and September 2014.

Overall, 73.1% of women underwent breast cancer screening. Patient ethnicity and the number of primary care visits had strong associations with screening rates, the group found.

However, after adjusting for patient-level characteristics, Onega and colleagues discovered that 24% of the overall breast cancer screening variation among primary care providers was due to practice factors, 35% to health system factors, and 41% to variations among providers within practices.

"After accounting for patient characteristics, the variation in breast cancer screening metrics was largely due to provider and health system variation rather than specific structural characteristics and process measures," the researchers concluded.