OBJECTIVES: The obtaining and avoidance of breast cancer screening (BCS) has a large effect on women’s health. Despite national campaigns to improve BCS, participation remain suboptimal among women in the United States. Therefore, The aims of this study were to evaluate the prevalence of BCS in women from the United States, and to identify predictors of BCS guided by Andersen’s Behavioral Model (ABM).

METHODS: This retrospective cross-sectional study analyzed BCS rates in women (aged≥ 18 years) using 2011 to 2015 data from Medical Expenditure Panel Survey (MEPS). Descriptive analytics were conducted to estimate if predisposing, enabling, and need factors are associated with BCS. Multivariable logistic regression within the framework of ABM was used to identify predictors of BCS. The outcome variables were a combination of mammogram screening (MS) and clinical breast examination (CBE) defined as BCS.

RESULTS: Among approximately 50,000 women, 74.04% (N = 37,080) reported obtaining a MS in the last 2 years and 95.04% (N =46,897) reported obtaining a CBE. Among predisposing factors age, race, income level, and employment status were significantly associated with obtaining BCS. Provider attitude, transportation, history of BC, insurance status, and obtaining preventative care over the past two years were significant enabling factors. Comorbidities, such as osteoarthritis and previous BC diagnosis, and health care provider attitude and recommendations were significant need factors. Women who drive (aOR: 3.47, 1.47-8.20) and had a history of BC (aOR: 3.09, 1.66-5.76) were 2.09 to 2.47 time more likely to obtain BCS compared to women who depended on other means of transportation. Women who were diagnosed with osteoarthritis (aOR: 1.39, 1.04-1.86) were 0.39 time more likely to obtain BCS compared to women who had other forms of arthritis.

CONCLUSIONS: The findings suggest health policy in the United States should concentrate on raising BCS by developing interventions that address these enabling factors among women.