Implementing breast cancer screening guidelines: Results of the Ontario Health Status Survey

Introduction: The Ontario Health Status Survey (OHS) was undertaken by the Ontario Ministry of Health in 1990 to provide data on factors related to health and health service use in a province of 10 million inhabitants. OHS analyses for this report focused on patterns of breast screening behaviors in relation to physician contact and various sociodemographic and psychological variables. Methods: The OHS was a probability sample survey using a multistage stratified cluster design to gather household-level data. SUDAAN was used to obtain population estimates for study variables. Data analyses were restricted to women 40 years of age and older. Results: Although over 85% of respondents reported contact with their physicians in the previous 12 months, most women did not adhere to recommended breast screening guidelines. Educational achievement, income adequacy, and smoking status were important factors explaining differences in screening behaviors. Conclusions: Physicians should not overlook opportunities to recommend mammography screening, where appropriate, and include breast examinations as part of regular physical exams. The involvement of educationally or economically disadvantaged women in the design of appropriate recruitment strategies for breast cancer screening would be informative. Medical Subject Headings (MeSH): mammography, screening, breast, guidelines.