Mammography Use in the U.S.: Trends and the Impact of Interventions

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Abstract
Mammography use has increased dramatically over the last five years. In 1990, 63% of U.S. women over age 40 reported ever having had a mammogram. The most important barriers to mammography have remained stable—lack of a physician recommendation and not knowing that mammograms are needed in the absence of symptoms. A range of interventions have been employed to increase mammography use. These include media campaigns, patient-directed interventions, system-directed or physician-directed interventions, access-enhancing interventions, policy-level interventions, social network interventions, and multi-strategy interventions. Six studies were reviewed in which single-intervention strategies were evaluated. Two of the six studies showed main effects; the others evidenced interventions. Fourteen studies included multi-strategy approaches to intervention: 11 of 14 had main effects. The others showed interactions. Thus, 33% of the single-intervention trials resulted in significant main effects compared to 85% of the multi-intervention studies. In the future, there should be more attention to standardization of measures and to the refinement of interventions for women over age 50 who are not currently getting regular mammograms.

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