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Showing content from https://pubmed.ncbi.nlm.nih.gov/29439783/ below:

Geographic access to mammography facilities and frequency of mammography screening

. 2018 Feb;28(2):65-71.e2. doi: 10.1016/j.annepidem.2017.11.012. Epub 2017 Dec 7. Geographic access to mammography facilities and frequency of mammography screening

Affiliations

¹ University of Wisconsin Carbone Cancer Center, Madison; Department of Population Health Sciences, University of Wisconsin, Madison. Electronic address: pjewett@wisc.edu.
² University of Wisconsin Carbone Cancer Center, Madison; Department of Population Health Sciences, University of Wisconsin, Madison; Department of Biostatistics and Medical Informatics, University of Wisconsin, Madison.
³ Department of Epidemiology and Biostatistics, Memorial Sloan-Kettering Cancer Center, New York, NY.
⁴ University of Wisconsin Carbone Cancer Center, Madison; Department of Population Health Sciences, University of Wisconsin, Madison.
⁵ University of Wisconsin Carbone Cancer Center, Madison; Department of Population Health Sciences, University of Wisconsin, Madison; Department of Medicine, University of Wisconsin, Madison.
⁶ Department of Urban and Regional Planning, University of Wisconsin, Madison.
⁷ Fred Hutchinson Cancer Research Center, Seattle, WA; University of Washington School of Public Health, Seattle.

PMID: 29439783
PMCID: PMC5819606
DOI: 10.1016/j.annepidem.2017.11.012

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Geographic access to mammography facilities and frequency of mammography screening

Patricia I Jewett et al. Ann Epidemiol. 2018 Feb.

. 2018 Feb;28(2):65-71.e2. doi: 10.1016/j.annepidem.2017.11.012. Epub 2017 Dec 7. Affiliations

¹ University of Wisconsin Carbone Cancer Center, Madison; Department of Population Health Sciences, University of Wisconsin, Madison. Electronic address: pjewett@wisc.edu.
² University of Wisconsin Carbone Cancer Center, Madison; Department of Population Health Sciences, University of Wisconsin, Madison; Department of Biostatistics and Medical Informatics, University of Wisconsin, Madison.
³ Department of Epidemiology and Biostatistics, Memorial Sloan-Kettering Cancer Center, New York, NY.
⁴ University of Wisconsin Carbone Cancer Center, Madison; Department of Population Health Sciences, University of Wisconsin, Madison.
⁵ University of Wisconsin Carbone Cancer Center, Madison; Department of Population Health Sciences, University of Wisconsin, Madison; Department of Medicine, University of Wisconsin, Madison.
⁶ Department of Urban and Regional Planning, University of Wisconsin, Madison.
⁷ Fred Hutchinson Cancer Research Center, Seattle, WA; University of Washington School of Public Health, Seattle.

PMID: 29439783
PMCID: PMC5819606
DOI: 10.1016/j.annepidem.2017.11.012

Item in Clipboard

Abstract

Purpose: To assess the association between geographic access to mammography facilities and women's mammography utilization frequency.

Methods: Using data from the population-based 1995-2007 Wisconsin Women's Health study, we used proportional odds and logistic regression to test whether driving times to mammography facilities and the number of mammography facilities within 10 km of women's homes were associated with mammography frequency among women aged 50-74 years and whether associations differed between Rural-Urban Commuting Areas and income and education groups.

Results: We found evidence for nonlinear relationships between geographic access and mammography utilization (nonlinear effects of driving times and facility density, P-values .01 and .005, respectively). Having at least one nearby mammography facility was associated with greater mammography frequency among urban women (1 vs. 0 facilities, odds ratio 1.26, 95% confidence interval, 1.09-1.47), with similar effects among rural women. Adding more facilities had decreasing marginal effects. Long driving times tended to be associated with lower mammography frequency. We found no effect modification by income, education, or urbanicity. In rural settings, mammography nonuse was higher, facility density smaller, and driving times to facilities were longer.

Conclusions: Having at least one mammography facility near one's home may increase mammography utilization, with decreasing effects per each additional facility.

Keywords: Health services accessibility; Mammography; Spatial epidemiology.

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Figures
Figure 1

Directed Acyclic Graph of the…

Figure 1

Directed Acyclic Graph of the associations between driving time and mammography facility density…

Figure 1

Directed Acyclic Graph of the associations between driving time and mammography facility density within residential neighborhood, and frequency of mammography screening use

Figure 2

Estimated spatial pattern of average…

Figure 2

Estimated spatial pattern of average annual mammography utilization in Wisconsin relative to location…

Figure 2

Estimated spatial pattern of average annual mammography utilization in Wisconsin relative to location of mammography facilities (black points) (N=5,930), Wisconsin Women’s Health Study, 1995–2007