Women's mammography experience and its impact on screening adherence.

OBJECTIVES Although rates for first-time and recent mammography screening have increased for women in the US in the past decade, rates for repeat mammography remain low. This study aimed to conduct an analysis of women's mammography experience, to examine the rates of repeat mammography and to identify the significant predictors of repeat mammography within 12 and 18 months of the index mammogram. METHODS Participants were 397 women obtaining a screening mammogram (i.e. index) at three university-affiliated radiology clinics. Following the index mammogram, women completed the measures assessing demographic background, health history, breast cancer knowledge, risk, and screening history, and aspects of the mammography experience. Eighteen months following the index mammogram, 296 women were contacted via telephone to assess repeat mammography behavior. RESULTS Factor analysis of a mammography experience survey yielded four major components including satisfaction with clinic services, physical experience, psychological experience, and communication with clinic staff. Twelve-month and 18-month repeat mammography rates were 37 and 68%, respectively. Logistic regression models found lifetime number of mammograms to predict repeat mammography at 12 and 18 months. In addition, the number of clinical breast exams obtained in the past 5 years predicted repeat mammography at 12 months, while having scheduled a mammography appointment predicted repeat mammography at 18 months. CONCLUSIONS Based on these findings, strategies to increase mammography adherence include implementing a formal reminder system that prompts patients (e.g. postcard, automated telephone call) to schedule an annual mammogram or training clinic staff to automatically schedule an annual mammogram at the time of the current screening appointment.