Primary doctors can help boost mammography compliance

2018 05 09 23 07 2005 Patient Hispanic 400

When primary care physicians (PCPs) are in regular contact with their patients, women are more likely to follow through on breast cancer screening, even among racial and ethnic minorities, according to a study published online February 5 in the Journal of the American College of Radiology.

The study findings offer a way to boost compliance among women who still experience care discrepancies compared to their white counterparts when it comes to breast cancer -- and suggest to radiologists a concrete way to participate in the effort, wrote a team led by Dr. Efrén Flores of Massachusetts General Hospital in Boston.

"Population health collaborations between radiology and primary care services have the potential to improve uptake of screening services at the population level for all racial/ethnic groups," the researchers wrote.

Primary care doctors are often responsible for monitoring a patient's adherence to preventive health measures, and previous studies have shown that frequent contact between women and their primary doctors positively influences their mammography screening participation, Flores and colleagues noted. But it's been unclear whether this effect is also present among women in racial or ethnic minority groups.

The researchers investigated the question by conducting a study that included 9,575 women between the ages of 50 and 64 who underwent baseline screening mammography in 2005. They tracked whether women returned for mammography every two years after this initial screening through 2015.

Patients were defined as having high levels of primary care physician contact if their PCP was listed among the top three providers with whom they had the most contact during the study period. Most of the women in the study sample were white (84.5%); 4.8% were black, 3% were Hispanic, 3.7% were Asian, and 4% were categorized as "other."

The investigators found high levels of PCP interaction among 37.3% of all women included in the study. And these interactions increased the odds -- across all racial and ethnic groups -- that the women would follow recommended screening mammography guidelines.

Effect of high levels of PCP interaction on compliance with screening mammography
Race Odds ratio p-value
White 1.51 < 0.001
Black 1.93 0.001
Hispanic 1.92 0.002
Asian 1.55 0.045
Other 2.18 0.002

The study suggests opportunities for radiologists to partner with their colleagues in primary care, according to the team.

"[Our] findings support the value of primary care for overall screening efforts and the importance of close collaboration of radiology practices with primary care practices to increase access and facilitate screening mammography participation for all eligible women," the researchers concluded.

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