Factors associated with having mammography examinations in primary health care users in Vitória, Espírito Santo, Brazil

Silva, Ranielle de Paula; Gigante, Denise Petrucci; Amorim, Maria Helena Costa; Leite, Franciele Marabotti Costa

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Epidemiologia e Serviços de Saúde

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ORIGINAL ARTICLE • Epidemiol. Serv. Saúde 28 (1) • 2019 • https://doi.org/10.5123/S1679-49742019000100010 copy

Factors associated with having mammography examinations in primary health care users in Vitória, Espírito Santo, Brazil^* * This article was derived from the bachelor degree course thesis entitled ‘Mammography adherence prevalence and associated factors: a study with women primary health care service users’, defended by Ranielle de Paula Silva at the Federal University of Espírito Santo Nursing Course in 2017. This study received funding from the Espírito Santo Research and Innovation Support Foundation (FAPES): Process No. 60530812/12.

Authorship SCIMAGO INSTITUTIONS RANKINGS

Abstract

Objectives:

to estimate prevalence and factors associated with having mammography examinations among adult women aged 40 to 59 years old in primary health care services.

Methods:

a cross-sectional study was performed in 26 health centers in Vitória, Espírito Santo, Brazil; data were collected from March to September 2014; the independent variables described sociodemographic, behavioral and reproductive characteristics, having mammography performed every two years as the outcome.

Results:

400 users participated, 57.8% of whom undergo mammography every two years; having the examination was more prevalent among women aged 50-59 years (PR=1.48 - 95%CI 1.25;1.75), those belonging to economic class A/B (PR=1.81 - 95%CI 1.22;2.68) and those who no longer menstruate (PR=1.31 - 95%CI 1.08;1.60).

Conclusion:

although the proportion of mammography examinations performed is in keeping with recommended levels, a higher frequency was found among the 50-59 age group belonging to class A/B, suggesting unequal access to this examination.

Keywords:
Mammography; Breast Neoplasms; Primary Health Care; Mass Screening; Health Services Accessibility

Variables	n (%)	95%CI^a
Sociodemographic
Age (in years)
40-49	225 (46.2)	51.3;61.1
50-59	175 (53.8)	38.9;48.7
Race/skin color^b
White	103 (26.6)	22.4;31.3
Black	84 (21.7)	17.9;26.1
Brown	200 (51.7)	46.7;56.6
Marital status
Without a partner	304 (76.0)	71.5;79.9
With a partner	96 (24.0)	20.1;28.4
Schooling (in completed years)
0-8	171 (42.7)	38.0;47.7
9-11	165 (41.3)	36.5;46.2
≥12	64 (16.0)	12.7;19.9
Paid job
No	156 (39.0)	34.3;43.9
Yes	244 (61.0)	56.1;65.7
Economic class^c
A/B	161 (40.3)	35.5;45.2
C	196 (49.0)	44.1;53.9
D/E	43 (10.8)	8.1;14.2
Behavioral
Smoker
No	354 (88.5)	85.0;91.3
Yes	46 (11.5)	8.7;15.0
Alcoholic drink consumption
No	260 (65.0)	60.2;69.5
Yes	140 (35.0)	30.5;39.8
Monthly breast self-examination
No	301 (75.3)	70.8;79.2
Yes	99 (24.7)	20.8;29.2
Reproductive
Menarche (in years)
<12	71 (17.8)	14.3;21.8
≥12	329 (82.2)	78.2;85.7
Currently menstruates
No	203 (50.8)	45.8;55.6
Yes	197 (49.2)	44.4;54.2
Number of pregnancies
None	30 (7.5)	5.3;10.5
1-2	159 (39.8)	35.0;44.7
≥3	211 (52.7)	47.8;57.6
Mammography every two years
No	169 (42.2)	37.5;47.2
Yes	231 (57.8)	52.3;62.5

Variables	Mammography every two years
Sociodemographic	n (%)	p-value^a
Age (in years)		<0.001
40-49	106 (47.1)
50-59	125 (71.4)
Race/skin color		0.322
White	64 (62.1)
Black	43 (51.2)
Brown	115 (57.5)
Marital status		0.078
Without a partner	183 (60.2)
With a partner	48 (50.0)
Schooling (in completed years)	0.003	0,003
0-8	85 (49.7)
9-11	99 (60.0)
≥12	47 (73.4)
Paid job		0.546
No	93 (59.6)
Yes	138 (56.6)
Economic class^b		<0.001
A/B	111 (68.9)
C	104 (53.1)
D/E	16 (37.2)
Behavioral
Smoker		0.147
No	209 (59.0)
Yes	22 (47.8)
Alcoholic drink consumption		0.414
No	154 (59.2)
Yes	77 (55.0)
Monthly breast self-examination		0.507
No	171 (56.8)
Yes	60 (60.6)
Reproductive
Menarche (in years)		0.289
<12	37 (52.1)
≥12	194 (59.0)
Currently menstruates		<0.001
No	141 (69.5)
Yes	90 (45.7)
Number of pregnancies		0.158
0	14 (46.7)
1-2	100 (62.9)
≥3	117 (55.5)

Variables	Crude analysis^a			Adjusted analysis^a
Variables	PR^b	95%CI^c	p-value	PR^b	95%CI^c	p-value
Sociodemographic
Age (in years)
40-49	1.00		<0.001	1.00		0.001
50-59	1.52	1.28;1.79		1.48	1.25;1.75
Marital status
Without a partner	1.00		0.099	1.00		0.221
With a partner	0.83	0.67;1.04		0.92	0.84;1.06
Schooling (in completed years)
0-8	1.00		0.001	1.00		0.239
9-11	1.21	0.99;1.47		1.12	0.91;1.37
≥12	1.48	1.20;1.82		1.23	0.97;1.58
Economic class^d
A/B	1.85	1.24;2.77	<0.001	1.81	1.22;2.68	0.001
C	1.42	0.94;2.15		1.46	0.97;2.16
D/E	1.00			1.00
Behavioral
Smoker
No	1.00		0.189	1.00		0.664
Yes	0.81	0.59;1.11		0.98	0.89;1.08
Reproductive
Currently menstruates
No	1.52	1.27;1.82	<0.001	1.31	1.08;1.60	0.007
Yes	1.00			1.00
Number of pregnancies
0	1.00		0.174	1.00		0.494
1-2	1.35	0.90;2.01		1.27	0.84;1.89
≥3	1.19	0.79;1.78		1.21	0.80;1.82

Secretaria de Vigilância em Saúde e Ambiente - Ministério da Saúde do Brasil SRTVN Quadra 701, Via W5 Norte, Lote D, Edifício P0700, CEP: 70719-040, +55 61 3315-3464, Fax: +55 61 3315-3464 - Brasília - DF - Brazil
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[1] Correspondence: Franciele Marabotti Costa Leite - Av. Marechal Campos, No. 1468, Campus de Maruípe, Vitória, ES, Brazil. Postcode: 29043-900. E-mail: francielemarabotti@gmail.com