TY - JOUR
T1 - Mammography Screening Practices in Average-Risk Women Aged 40-49 Years in Primary Care
T2 - A Comparison of Physician and Nonphysician Providers in Minnesota
AU - Martin, Katherine
AU - Vogel, Rachel I.
AU - Nagler, Rebekah H.
AU - Wyman, Jean F.
AU - Raymond, Nancy
AU - Teoh, Deanna
AU - Allen, Alicia M.
AU - Talley, Kristine M.C.
AU - Mason, Susan
AU - Blaes, Anne H.
N1 - Publisher Copyright:
© Mary Ann Liebert, Inc., publishers 2020.
PY - 2020/1
Y1 - 2020/1
N2 - Breast cancer screening practices and the influence of clinical guidelines or recommendations are well documented for physicians, but little is known about the screening practices of nonphysician providers (physician assistants and advanced practice registered nurses). The seven breast cancer screening guidelines or recommendations on the use of mammography have the most variation for screening average-risk women 40-49 years of age. Therefore, to better understand the practices of nonphysicians, this study will compare the practices of physicians with nonphysician providers for women 40-49 years of age. Materials and Methods: Minnesota physicians and nonphysicians were e-mailed an anonymous cross-sectional survey, which asked primary care providers about their mammography screening practices for average-risk women 40-44 and 45-49 years of age and to rate the influence of seven breast cancer screening recommendations on the use of mammography in their practice. Comparisons across providers' demographic and professional characteristics were conducted using chi-squared and Fisher's exact tests, as appropriate, and multivariate logistic regression analyses. Results: Of the respondents who practiced primary care (193 physicians, 50 physician assistants, and 197 advanced practice registered nurses), 66.7% reported recommending mammography for women at ages 40-44 and 77.2% recommended mammography for women at ages 45-49. Nonphysician providers were more likely to recommend screening in both these age groups (p < 0.05). Having a self-identified interest in women's health was associated with more mammography screening in both age groups. The American Cancer Society guideline was endorsed as influential by the most respondents. Conclusions: Breast cancer screening practices vary between physicians and nonphysician providers for women 40-49 years of age at average risk. Targeted interventions may help reduce practice variation and ensure high-value care.
AB - Breast cancer screening practices and the influence of clinical guidelines or recommendations are well documented for physicians, but little is known about the screening practices of nonphysician providers (physician assistants and advanced practice registered nurses). The seven breast cancer screening guidelines or recommendations on the use of mammography have the most variation for screening average-risk women 40-49 years of age. Therefore, to better understand the practices of nonphysicians, this study will compare the practices of physicians with nonphysician providers for women 40-49 years of age. Materials and Methods: Minnesota physicians and nonphysicians were e-mailed an anonymous cross-sectional survey, which asked primary care providers about their mammography screening practices for average-risk women 40-44 and 45-49 years of age and to rate the influence of seven breast cancer screening recommendations on the use of mammography in their practice. Comparisons across providers' demographic and professional characteristics were conducted using chi-squared and Fisher's exact tests, as appropriate, and multivariate logistic regression analyses. Results: Of the respondents who practiced primary care (193 physicians, 50 physician assistants, and 197 advanced practice registered nurses), 66.7% reported recommending mammography for women at ages 40-44 and 77.2% recommended mammography for women at ages 45-49. Nonphysician providers were more likely to recommend screening in both these age groups (p < 0.05). Having a self-identified interest in women's health was associated with more mammography screening in both age groups. The American Cancer Society guideline was endorsed as influential by the most respondents. Conclusions: Breast cancer screening practices vary between physicians and nonphysician providers for women 40-49 years of age at average risk. Targeted interventions may help reduce practice variation and ensure high-value care.
KW - breast cancer
KW - cancer screening recommendations
KW - health care providers
KW - mammography screening
KW - practice patterns
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U2 - 10.1089/jwh.2018.7436
DO - 10.1089/jwh.2018.7436
M3 - Article
C2 - 31314684
AN - SCOPUS:85077943274
SN - 1540-9996
VL - 29
SP - 91
EP - 99
JO - Journal of Women's Health
JF - Journal of Women's Health
IS - 1
ER -