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April 12, 1995, Vol 273, No. 14 >
ARTICLE | April 12, 1995

Cancer Screening Behaviors and Attitudes of Women in Southeastern Minnesota FREE

Thomas E. Kottke, MD, MSPH; Mary Alice Trapp, RN; Maria M. Fores, MD; Ann W. Kelly, PhD; Sin-ho Jung, PhD; Paul J. Novotny, MS; Laurel A. Panser, MA, MS
[+] Author Affiliations

Reprint requests to Harwick 6, Mayo Clinic and Foundation, Rochester, MN 55905 (Dr Kottke).


JAMA. 1995;273(14):1099-1105. doi:10.1001/jama.1995.03520380035032
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References

Objective.  —To determine the rates at which women received screening Papanicolaou tests, clinical breast examinations, and mammography and to determine the extent to which these women might be expected to respond to screening recommendations from their physicians.

Design.  —Random-digit-dial telephone interviews conducted in January 1993.

Setting.  —Fifteen counties in southeastern Minnesota.

Subjects.  —A sample of 1019 women who completed the telephone interview.

Main Outcome Measures.  —Self-reported Papanicolaou test, clinical breast examination, and mammography screening rates, with verification from medical records for a randomly selected subsample of 200 respondents who reported having had a test within 1 year of the interview.

Results.  —For women aged 18 years and older, 60% (95% confidence interval, ±3.4%) reported having had a Papanicolaou test within the preceding year. For women 40 years of age and older, 57% (95% confidence interval, ±3.5%) reported having had a clinical breast examination in the past year, and 46% (95% confidence interval, ±3.6%) reported having had a screening mammogram within 1 year. The verified 1-year Papanicolaou test and mammogram rates were 35% and 33%, respectively. More than 90% of the respondents expressed a willingness to have these tests if their physicians were to advise them that the tests were indicated. However, 53% and 54% of the respondents, respectively, said that they either did not care or did not want their physicians to remind them when they were due for a Papanicolaou test or a mammogram.

Conclusions.  —Although self-reported screening rates in this population meet Healthy People 2000 goals, verified rates were significantly below target levels. A substantial proportion of women in this population remain ambivalent about participating in cancer detection programs.(JAMA. 1995;273:1099-1105)

REFERENCES

1 +
US Preventive Services Task Force. Guide to Clinical Preventive Services: An Assessment of the Effectiveness of 169 Interventions . Baltimore, Md: William & Wilkins Co; 1989;:39-42, 57-58.
2 +
Healthy People 2000: National Health Promotion and Disease Prevention Objectives . Washington, DC: Dept of Health and Human Services; 1991;. Publication PHS 91-50212.
3 +
Siegel PZ, Frazier EL, Mariolis P, Brackbill RM, Smith C.  Behavioral risk factor surveillance, 1991: monitoring progress toward the nation's year 2000 health objectives. MMWR Morb Mortal Wkly Rep . 1993;;42:1-21.
4 +
Zapka JG, Berkowitz E.  A qualitative study about breast cancer screening in older women: implications for research. J Gerontol . 1992;;47:93-100.
5 +
Rimer BK, Trock B, Balshem A, et al.  Breast screening practices among primary physicians: reality and potential. J Am Board Fam Pract . 1990;; 3:26-34.
6 +
Cummings KM, Funch DP, Mettlin C, Jennings E.  Family physicians' beliefs about breast cancer screening by mammography. J Fam Pract . 1983;; 17:1029-1034.
7 +
Weinberger M, Saunders AF, Samsa GP, et al.  Breast cancer screening in older women: practices and barriers reported by primary care physicians. J Am Geriatr Soc . 1991;;39:22-29.
8 +
Lerman C, Rimer B, Trock B, Balshem B, Engstrom PF.  Factors associated with repeat Adherence to breast cancer screening. Prev Med . 1990;; 19:279-291.
9 +
Kee F, Telford AM, Donaghy P, O'Doherty A.  Attitude or access: reasons for not attending mammography in Northern Ireland. Eur J Cancer Prev . 1992;;1:311-315.
10 +
Murray M, McMillan C.  Social and behavioural predictors of women's cancer screening practices in Northern Ireland. J Public Health Med . 1993;;15: 147-153.
11 +
Ackermann SP, Brackbill RM, Bewerse BA, Cheal NE, Sanderson LM.  Cancer screening behaviors among U.S. women: breast cancer, 1987-1989, and cervical cancer, 1988-1989. MMWR CDC Surveill Summ . 1992;;41:17-25.
12 +
SAS/STAT Users Guide, Vol 2, Version 6 . 4th ed. Cary, NC: SAS Institute Inc; 1990;:1071-1126.
13 +
Akaike H.  Information theory and an extension of the maximum likelihood principle.  In: Petrov BN, Czaki F, eds. Second International Symposium on Information Theory . Budapest, Hungary: Akademiai Kiado; 1973;:267-281.
14 +
Sawyer JA, Earp JA, Fletcher RH, Daye FF, Wynn TM.  Accuracy of women's self-report of their last Pap smear. Am J Public Health . 1989;;79:1036-1037.
15 +
Warnecke RB, Graham S.  Characteristics of blacks obtaining Papanicolaou smears. Cancer . 1976;; 37:2015-2025.
16 +
King ES, Rimer BK, Trock B, Balshem A, Engstrom P.  How valid are mammography self-reports? Am J Public Health . 1990;;80:1386-1388.
17 +
Moodie PJ, Kljakovic M, McLeod DK.  An audit of a cervical smear screening programme. N Z Med J . 1989;;102:374-376.
18 +
Rogers EM. Diffusion of Innovation . 3rd ed. New York, NY: Free Press; 1983;:250.
19 +
Molleman E, Krabbendam PJ, Annyas AA, Koops HS, Sleijfer DT, Vermey A.  The significance of the doctor-patient relationship in coping with cancer. Soc Sci Med . 1984;;18:475-480.
20 +
Steptoe A, Sutcliffe I, Allen B, Coombes C.  Satisfaction with communication, medical knowledge, and coping style in patients with metastatic cancer. Soc Sci Med . 1991;;32:627-632.
21 +
Mosely R.  Excuse me, but you have a melanoma on your neck! unsolicited medical opinions. J Med Philos . 1985;;10:163-170.
22 +
Ratzan RM.  Unsolicited medical opinion. J Med Philos . 1985;;10:147-162.
23 +
Freidson E. Profession of Medicine. A Study of the Sociology of Applied Knowledge . New York, NY: Dodd Mead & Co; 1970;:355-356.
24 +
Kottke TE, Willms DG, Solberg LI, Brekke ML.  Physician-delivered smoking cessation advice: issues identified during ethnographic interviews. Tobacco Control . 1994;;3:46-49.
25 +
Kottke TE, Solberg LI, Brekke ML.  Initiation and maintenance of patient behavioral change: what is the role of the physician? J Gen Intern Med . 1990;;5:S62-S67.
26 +
Kottke TE, Brekke ML, Solberg LI.  Making 'time' for preventive services. Mayo Clin Proc . 1993;;68:785-791.
27 +
Resnik MD. Choices: An Introduction to Decision Theory . Minneapolis: University of Minnesota Press; 1987;:8-12.
28 +
Kahneman D, Tversky A.  The psychology of preferences. Sci Am . 1982;;246:160-173.
29 +
Skinner BF. Cumulative Record . Cambridge, Mass: Harvard University Press; 1959;:21.
30 +
Bandura A. Social Learning Theory . Engle-wood Cliffs, NJ: Prentice-Hall; 1977;:50-55.

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Country-Specific Mortality and Growth Failure in Infancy and Yound Children and Association With Material Stature

Use interactive graphics and maps to view and sort country-specific infant and early dhildhood mortality and growth failure data and their association with maternal

1 +
US Preventive Services Task Force. Guide to Clinical Preventive Services: An Assessment of the Effectiveness of 169 Interventions . Baltimore, Md: William & Wilkins Co; 1989;:39-42, 57-58.
2 +
Healthy People 2000: National Health Promotion and Disease Prevention Objectives . Washington, DC: Dept of Health and Human Services; 1991;. Publication PHS 91-50212.
3 +
Siegel PZ, Frazier EL, Mariolis P, Brackbill RM, Smith C.  Behavioral risk factor surveillance, 1991: monitoring progress toward the nation's year 2000 health objectives. MMWR Morb Mortal Wkly Rep . 1993;;42:1-21.
4 +
Zapka JG, Berkowitz E.  A qualitative study about breast cancer screening in older women: implications for research. J Gerontol . 1992;;47:93-100.
5 +
Rimer BK, Trock B, Balshem A, et al.  Breast screening practices among primary physicians: reality and potential. J Am Board Fam Pract . 1990;; 3:26-34.
6 +
Cummings KM, Funch DP, Mettlin C, Jennings E.  Family physicians' beliefs about breast cancer screening by mammography. J Fam Pract . 1983;; 17:1029-1034.
7 +
Weinberger M, Saunders AF, Samsa GP, et al.  Breast cancer screening in older women: practices and barriers reported by primary care physicians. J Am Geriatr Soc . 1991;;39:22-29.
8 +
Lerman C, Rimer B, Trock B, Balshem B, Engstrom PF.  Factors associated with repeat Adherence to breast cancer screening. Prev Med . 1990;; 19:279-291.
9 +
Kee F, Telford AM, Donaghy P, O'Doherty A.  Attitude or access: reasons for not attending mammography in Northern Ireland. Eur J Cancer Prev . 1992;;1:311-315.
10 +
Murray M, McMillan C.  Social and behavioural predictors of women's cancer screening practices in Northern Ireland. J Public Health Med . 1993;;15: 147-153.
11 +
Ackermann SP, Brackbill RM, Bewerse BA, Cheal NE, Sanderson LM.  Cancer screening behaviors among U.S. women: breast cancer, 1987-1989, and cervical cancer, 1988-1989. MMWR CDC Surveill Summ . 1992;;41:17-25.
12 +
SAS/STAT Users Guide, Vol 2, Version 6 . 4th ed. Cary, NC: SAS Institute Inc; 1990;:1071-1126.
13 +
Akaike H.  Information theory and an extension of the maximum likelihood principle.  In: Petrov BN, Czaki F, eds. Second International Symposium on Information Theory . Budapest, Hungary: Akademiai Kiado; 1973;:267-281.
14 +
Sawyer JA, Earp JA, Fletcher RH, Daye FF, Wynn TM.  Accuracy of women's self-report of their last Pap smear. Am J Public Health . 1989;;79:1036-1037.
15 +
Warnecke RB, Graham S.  Characteristics of blacks obtaining Papanicolaou smears. Cancer . 1976;; 37:2015-2025.
16 +
King ES, Rimer BK, Trock B, Balshem A, Engstrom P.  How valid are mammography self-reports? Am J Public Health . 1990;;80:1386-1388.
17 +
Moodie PJ, Kljakovic M, McLeod DK.  An audit of a cervical smear screening programme. N Z Med J . 1989;;102:374-376.
18 +
Rogers EM. Diffusion of Innovation . 3rd ed. New York, NY: Free Press; 1983;:250.
19 +
Molleman E, Krabbendam PJ, Annyas AA, Koops HS, Sleijfer DT, Vermey A.  The significance of the doctor-patient relationship in coping with cancer. Soc Sci Med . 1984;;18:475-480.
20 +
Steptoe A, Sutcliffe I, Allen B, Coombes C.  Satisfaction with communication, medical knowledge, and coping style in patients with metastatic cancer. Soc Sci Med . 1991;;32:627-632.
21 +
Mosely R.  Excuse me, but you have a melanoma on your neck! unsolicited medical opinions. J Med Philos . 1985;;10:163-170.
22 +
Ratzan RM.  Unsolicited medical opinion. J Med Philos . 1985;;10:147-162.
23 +
Freidson E. Profession of Medicine. A Study of the Sociology of Applied Knowledge . New York, NY: Dodd Mead & Co; 1970;:355-356.
24 +
Kottke TE, Willms DG, Solberg LI, Brekke ML.  Physician-delivered smoking cessation advice: issues identified during ethnographic interviews. Tobacco Control . 1994;;3:46-49.
25 +
Kottke TE, Solberg LI, Brekke ML.  Initiation and maintenance of patient behavioral change: what is the role of the physician? J Gen Intern Med . 1990;;5:S62-S67.
26 +
Kottke TE, Brekke ML, Solberg LI.  Making 'time' for preventive services. Mayo Clin Proc . 1993;;68:785-791.
27 +
Resnik MD. Choices: An Introduction to Decision Theory . Minneapolis: University of Minnesota Press; 1987;:8-12.
28 +
Kahneman D, Tversky A.  The psychology of preferences. Sci Am . 1982;;246:160-173.
29 +
Skinner BF. Cumulative Record . Cambridge, Mass: Harvard University Press; 1959;:21.
30 +
Bandura A. Social Learning Theory . Engle-wood Cliffs, NJ: Prentice-Hall; 1977;:50-55.

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