Rationale and Objectives
The aim of this study was to explore women’s interest and preferences in undergoing screening mammography in a retail health care setting.
Materials and Methods
Self-administered surveys were distributed to 400 mammography patients in May to June 2009. All of the women who were asked were eligible for screening (age >40 years, no abnormal mammographic findings in the recent past). Three hundred eighty-six screening-eligible women filled out and returned the self-administered survey.
Results
The average respondent age was 57 years. Three hundred ten of the patients (80.3%) had college or postgraduate educations. Two hundred three (52.6%) reported annual incomes >$60,000. Two hundred forty-one respondents (62.4%) had been undergoing screening mammography for >10 years, while this was the first examination for eight patients (2%). More than half of the patients ( n = 215 [55.7%]) affirmed their interest in undergoing annual screening mammography in a private area within a retail shopping facility. Most preferred a pharmacy (77%) over Wal-Mart or a grocery store. Appealing factors about a retail setting were proximity to home (90%), free parking (62%), and operating hours (48.8%).
Conclusions
There is interest among women in undergoing screening mammography at retail health care clinics, preferably pharmacies. The provision of services at a convenient location can increase adherence to guidelines for screening mammography.
In the United States, breast cancer is the most common cancer in women and is the second leading cause of female cancer mortality . Fortunately, since the early 1990s, US female breast cancer mortality rates and the lifetime risk for developing breast cancer have slowly decreased . Of the various factors that have contributed to reducing breast cancer mortality, screening mammography has played an important role. Large population studies have shown that regular screening mammography reduces breast cancer mortality by between 14% and 63% . The large range is explained by the confounding mortality reduction caused by advances in treatment of screen-detected cancers .
The percentage of women aged >40 years who reported undergoing mammography in the previous 2 years in the United States increased from 39.1% in 1987 to 75.4% in 2010 . However, according to the Centers for Disease Control and Prevention, significant socioeconomic disparity in screening mammography rates persists. For example, women with less than a high school education, those without health insurance, and those with annual incomes <$15,000 were least likely to have undergone mammography . Of the various factors attributed to this disparity, out-of-pocket costs (such as those associated with travel, dependent care, parking, etc) convenience to mammographic services, and lack of awareness about the benefits of screening have been found to be the most important .
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Materials and methods
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Study Sample
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Survey Instrument
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Results
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Table 1
Demographic Profile of the Study Population: Various Characteristics of Women Who Were Surveyed Regarding Their Preferences for Retail-based Screening Mammography
Characteristic_n_ % 95% Confidence Interval Age (y) <40 7 1.80% 0.48%–3.1% 40–49 105 27.20% 22.8%–31.6% 50–64 175 45.30% 40.4%–50.3% ≥65 93 24.10% 19.8%–28.4% Missing/unsure 6 1.60% 0.32%–2.8% Total 386 Highest level of education completed Less than high school 0 0% — High school 64 16.60% 12.9%–20.3% College 190 49.20% 44.2%–54.2% Postgraduate degree 120 31.10% 26.5%–35.7% Missing/unsure 12 3.10% 1.4%–4.8% Total 386 Average yearly income <$10,000 18 4.70% 2.6%–6.9% $10,000–$19,999 8 2.10% 0.7%–3.7% $20,000–$39,999 39 10.10% 7.1%–13.3% $40,000–$60,000 62 16.10% 12.4%–19.9% $60,000–$99,999 81 21.00% 16.9%–25.3% >$100,000 122 31.60% 26.9%–36.4% Missing/unsure 56 14.50% 10.9%–18.2% Total 386 Date of first screening mammographic exam First exam 8 2.10% 0.7%–3.8% 1–5 years ago 52 13.50% 10.1%–16.9% 5–10 years ago 79 20.50% 16.4%–24.6% >10 years ago 241 62.40% 57.6%–67.6% Missing/unsure 6 1.60% 0.3%–2.10% Total 386 Date of last mammographic exam First exam 7 1.80% 0.5%–3.1% <1 year ago 31 8.00% 5.3%–10.10% 1 year ago 287 74.40% 70.0%–78.9% 1–5 years ago 50 13.00% 9.6%–16.4% >5 years ago 5 1.30% 0.2%–2.6% Missing/unsure 6 1.60% 0.3%–2.10% Total 386
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Table 2
Preferences for Retail Venue–based Screening Mammography: Various Factors Women Prefer in Considering Annual Screening Mammography in a Retail Venue–based Health Care Setting
Characteristic_n_ % 95% Confidence Interval 1. Interest in getting screened at a retail/shopping location Yes 215 55.70% 50.7%–60.7% No 164 42.50% 37.6%–47.4% Missing/unsure 7 1.80% 0.5%–3.1% Total 386 2. Preference of location ∗,† Grocery store (ie, Shaw’s) 31 14.40% 9.7%–19.1% Pharmacy/drug stores (ie, CVS) 165 76.70% 71.1%–82.5% Other (ie, Wal-Mart) 42 19.50% 14.2%–24.8% Missing/unsure 18 7.00% 3.3%–10.7% Total 215 3. Preference of set appointment time vs unscheduled walk-in services ∗,† Set appointment time 168 78.10% 72.6%–83.7% Walk-in 49 22.80% 17.2%–28.4% Missing/unsure 5 2.30% 0.3%–4.3% Total 215 4. Factors of the location considered appealing ∗,† Closer to home 193 89.80% 85.7%–93.8% Free and convenient parking 133 61.90% 55.4%–68.4% Convenient operating hours 105 48.80% 42.2%–55.5% On-site childcare 6 2.80% 0.6%–5.0% Total 215 5. Time considered most convenient for undergoing screening mammography † 9 am to 5 pm 243 63.00% 58.1%–67.8% 5 to 7 pm 91 23.60% 19.3%–27.8% 7 to 9 pm 65 16.80% 13.1%–20.6% After 9 pm 11 2.80% 1.2%–4.5% Blank 22 5.70% 3.4%–8.0% Total 386 6. Have children aged <13 y Yes 59 15.30% 11.7%–18.9% No 322 83.40% 79.7%–87.1% Blank 5 1.30% 0.2%–2.4% Total 386 7. Did the inability to secure babysitting ever result in a missed doctor’s appointment ‡ Yes 17 28.80% 17.3%–40.4% No 42 71.20% 59.6%–82.7% Total 59 8 Did the inability to secure babysitting ever keep the subject from undergoing mammography ‡ Yes 4 6.80% 0.4%–13.2% No 54 91.50% 84.4%–98.6% Blank 1 1.70% 1.6–5.0% Total 59
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Discussion
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Conclusions
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