Persistence with Mammography Screening and Stage at Breast Cancer Diagnosis among Elderly Appalachia-West Virginia Women

The objective of this study is to evaluate the association between persistence with mammography screening and stage at breast cancer diagnosis in elderly Appalachia-West Virginia women diagnosed with first incident breast cancer. The study utilized West Virginia Cancer Registry-Medicare linked database to identify women age 70 and above diagnosed with first incident breast cancer in 2007. Persistence to mammography screening was defined as having had at least three mammography screenings before breast cancer diagnosis. A multiple logistic regression was conducted to assess the association between persistence with mammography screening and stage at breast cancer diagnosis in these women. Of the 221 elderly Appalachia-West Virginia women included in the analysis, 113 women (51.1%) were persistent to mammography screening before their diagnosis with breast cancer. In a multiple logistic regression after adjusting for all the variables, as compared to elderly women who were not persistent with mammography screening, women who were persistent with mammography screening were significantly more likely to be diagnosed with early stage breast cancer (adjusted odds ratio=4.25, 95% confidence interval=1.96-9.19). Persistence with mammography screening is significantly associated with earlier stages of breast cancer in the rural and underserved AppalachiaWest Virginia women. The study findings suggest targeting interventions to encourage regular mammography in these women for whom there are no clear guidelines.