Measuring Women's Compliance to Guidelines for Getting Mammograms

• Activity Number: 316
• Type: Invited
• Date/Time: Tuesday, August 3, 2010 : 10:30 AM to 12:20 PM
• Sponsor: Biometrics Section
• Author(s): Jane F. Gentleman*+ and Nancy Breen and Judith H. Mopsik and Jeannine Schiller and Pete Welch
• Companies: National Center for Health Statistics and National Cancer Institute and The Lewin Group and National Center for Health Statistics and The Lewin Group
• Keywords: mammography screening guidelines ; National Health Interview Survey ; UnitedHealth Group claims database ; time intervals between mammograms ; Guideline Boundary Effect ; GBE

Abstract

This paper is part of a project to analyze time intervals between mammograms using 2008 National Health Interview Survey data and 2006-2008 claims data from a UnitedHealth Group medical insurance database. Our analysis of the claims data reveals what we have termed the "Guideline Boundary Effect" (GBE), i.e., that significant numbers of screenings occur after but not long after the time boundary (one year) specified by screening frequency guidelines. We show that the GBE resulted, for example, in the percentage of 55-year-old women who had their last two mammograms less than 13 months apart (54%) being appreciably lower than the percentage who had them less than 14 months apart (68%). We compare mammography screening rates for the U.S. and Canada and discuss possible reasons why Canadian rates are not higher than U.S. rates, and how the GBE may cause misperception of the difference.