Compliance with mammography guidelines: physician recommendation and patient adherence

UMMS Affiliation

Department of Quantitative Health Sciences

Publication Date


Document Type



Aged; Alabama; Breast Neoplasms; Female; Guideline Adherence; Health Care Surveys; Humans; Insurance, Health; Mammography; Middle Aged; Patient Compliance; Physician's Practice Patterns; Practice Guidelines as Topic; Primary Health Care; Referral and Consultation; Retrospective Studies; Statistics as Topic


Bioinformatics | Biostatistics | Epidemiology | Health Services Research


BACKGROUND: Guidelines recommend that women ages 50-75 years receive screening mammography every 1-2 years. We related receipt of physician recommendations for mammography and patient adherence to such recommendations to several patient characteristics.

METHODS: We retrospectively reviewed medical records of 1,111 women ages 50-75 attending three clinics in an urban university medical center. We ascertained overall compliance with mammography guidelines and two components of compliance: receipt of a physician recommendation and adherence to a recommendation. Outcome measures were the proportion of patients demonstrating each type of compliance and adjusted odds ratios, according to several patient-related characteristics.

RESULTS: Overall, 66% of women received a recommendation. Of women receiving a documented recommendation, 75% adhered. Factors showing significant positive associations with receiving a recommendation included being a patient in the general internal medicine clinic, having private insurance, visiting the clinic more often, and having a recent Pap smear. Patient adherence was positively associated with private insurance and Pap smear history, negatively associated with internal medicine, and not associated with visit frequency.

CONCLUSIONS: Patient factors influencing physician mammography recommendations may be different from those associated with patient adherence, except for having private health insurance, which was a predictor of both.

DOI of Published Version



Prev Med. 1999 Apr;28(4):386-94. Link to article on publisher's site

Journal/Book/Conference Title

Preventive medicine

PubMed ID


Related Resources

Link to Article in PubMed