Breast cancer screening in Rockland County, New York: a survey of attitudes and behaviors.

OBJECTIVES Higher-than-average breast cancer incidence and mortality rates in Rockland County (NY) may be explained by higher screening rates, but screening frequency has not been measured at the county level. This study was conducted to determine adherence to breast cancer screening guidelines in Rockland, and whether adherence differs by ethnicity, age, educational level, insurance status, and race. METHODS A telephone survey of screening behaviors and attitudes was administered to a random sample of Rockland County women age > or = 40 years. Prevalence estimates of mammography, clinical breast exam (CBE), and breast self-examination (BSE) were derived by using exact confidence intervals (CIs) for proportions. Differences in demographic groups were assessed with chi-square tests and 95% CIs. Logistic regression was used to determine independent contributions of demographic characteristics after adjustment. RESULTS Overall, 76.4% of respondents received a mammogram and CBE in the past year, compared with 60.3% in New York State and 55.5% in the United States. Significant predictors of a mammogram in the past year were age, education, marital status, and health insurance; of CBE in the past year were age, education, and marital status; of BSE at least monthly was marital status. Being Jewish was associated with a mammogram and CBE in the past year but did not attain significance (P = .06 and .08, respectively). CONCLUSIONS Mammography and CBE usage in Rockland County appear to exceed that of New York State and the United States. The county health department can target relevant demographic subgroups for health education programs.