Womenʹs primary care providers and breast cancer screening: Whoʹs following the guidelines?

Objective Screening mammography for woman ages 50 to 69 years has resulted in early breast cancer detection and reduced mortality rates. However, the providers who are responsible for womenʹs preventive health care differ in breast cancer screening guideline adherence. We compared screening practices across provider specialty and training degree types. Study design Using a retrospective cohort design, we examined 472 patient records that represented 16 million preventive health care visits among women ages 50 to 69 years from the 2000 National Ambulatory Medical Care Survey. We calculated relative risk ratios for breast examination and mammography during preventive visits across provider specialty and training types. Results Among specialists, gynecologists are more likely than internists or general/family practitioners to follow breast cancer screening guidelines. Across training degree types, mid-level providers are more likely than medical doctors or osteopaths to adhere to guidelines. Conclusion Regardless of specialty type or training degree, womenʹs health care providers should adhere to breast cancer screening guidelines during preventive care visits