Health care utilization, lifestyle, and emotional factors and mammography practices in the Childhood Cancer Survivor Study Journal Article


Authors: Rosenberg, S. M.; Moskowitz, C. S.; Ford, J. S.; Henderson, T. O.; Frazier, A. L.; Diller, L. R.; Hudson, M. M.; Stanton, A. L.; Chou, J. F.; Smith, S.; Leisenring, W. M.; Mertens, A. C.; Cox, C. L.; Nathan, P. C.; Krull, K. R.; Robison, L. L.; Oeffinger, K. C.
Article Title: Health care utilization, lifestyle, and emotional factors and mammography practices in the Childhood Cancer Survivor Study
Abstract: Background: Women with a history of chest radiotherapy have an increased risk of breast cancer; however, many do not undergo annual recommended screening mammography. We sought to characterize the relationship between mammography and potentially modifiable factors, with the goal of identifying targets for intervention to improve utilization. Methods: Of 625 female participants sampled from the Childhood Cancer Survivor Study, who were treated with chest radiotherapy, 551 responded to a survey about breast cancer screening practices. We used multivariate Poisson regression to assess several lifestyle and emotional factors, health care practices, and perceived breast cancer risk, in relation to reporting a screening mammogram within the last two years. Results: Women who had a Papanicolaou test [prevalence ratio (PR):1.77; 95% confidence interval (CI) 1.26-2.49], and who perceived their breast cancer risk as higher than the average woman were more likely to have had a mammogram (PR, 1.26; 95% CI, 1.09-1.46). We detected an attenuated effect of echocardiogram screening [PR, 0.70; 95% CI (0.52-0.95)] on having a mammogram among older women compared with younger women. Smoking, obesity, physical activity, coping, and symptoms of depression and somatization were not associated with mammographic screening. Conclusion: Our findings suggest that compliance with routine and risk-based screening can be an important indicator of mammography in childhood cancer survivors. In addition, there is a need to ensure women understand their increased breast cancer risk, as a means to encouraging them to follow breast surveillance guidelines. Impact: Screening encounters could be used to promote mammography compliance in this population. © 2015 AACR.
Keywords: adult; major clinical study; cancer risk; breast cancer; obesity; smoking; childhood cancer; cancer survivor; health care utilization; depression; mammography; anxiety disorder; emotion; coping behavior; physical activity; echocardiography; lifestyle; underweight; papanicolaou test; health care practice; somatization; human; female; priority journal; article
Journal Title: Cancer Epidemiology Biomarkers and Prevention
Volume: 24
Issue: 11
ISSN: 1055-9965
Publisher: American Association for Cancer Research  
Date Published: 2015-11-01
Start Page: 1699
End Page: 1706
Language: English
DOI: 10.1158/1055-9965.epi-14-1377
PROVIDER: scopus
PMCID: PMC4633330
PUBMED: 26304504
DOI/URL:
Notes: Export Date: 2 December 2015 -- Source: Scopus
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MSK Authors
  1. Joanne Fu-Lou Chou
    333 Chou
  2. Stephanie M Smith
    6 Smith
  3. Jennifer S Ford
    63 Ford
  4. Chaya S. Moskowitz
    281 Moskowitz
  5. Kevin Oeffinger
    297 Oeffinger