Self-Report and Primary Care Medical Record Documentation of Mammography: DISCUSSION

This study identified high rates of self-reported breast and cervical cancer screening among poor, African-American, Puerto Rican women and non-Hispanic white women living in the inner-city with access to primary care. This shows that primary care truly can have a positive impact on the receipt of preventive health services among minority, low-income women. The screening rates found in this study were compared to national averages. Receipt of a Pap smear in the past three years according to self-report (96%) and chart review (92%) exceeds the Healthy People 2010 goal of 90%. Self report of mammography in this study (91%) exceeds the Health People 2010 goal of 70% of women over 40 receiving a mammogram within the preceding two years. However, chart documentation of mammography (57%) is below the 2010 goal. This study used 1997 American Cancer Society Guidelines to assess appropriateness of screening. We did not assess the guidelines that the patients’ physicians inherently followed if any. Self-report of receipt of mammography and Pap smear was consistently higher than medical record documentation of screening. Self-report misrepresented actual screening practices as identified by high sensitivity rates and low specificity rates. However, high negative predictive values suggested that asking women about their recent mammography use may be an inexpensive, easy intervention to increase screening among women currently not being screened by encouraging dialog between patient and provider about reasons for not being screened and/or other means of obtaining screens.










