OBJECTIVES: Despite the national campaign and multiple efforts to reduce the mortality associated with Breast Cancer (BC), mammography screening participation rates remain below the goal set by American Cancer Society (ACS) for the early detection of cancer. The access of mammography screening (MS) and clinical breast examination (CBE) could be improved if potential factors that impact nonattendance were better understood. Therefore, the objective of this study is to evaluate the predictors of breast cancer screening (BCS) behaviors within the frame work of Health belief model.

METHODS: This retrospective cross-sectional study evaluated the BCS rates in women (aged≥ 18 years) utilizing 2011 to 2015 MEPS data. This study design addressed constructs of Health belief model (HBM) and applied logistic regression model to estimate predictor variables associated with BC screening. The outcome variable BCS was defined as those who received MS and CBE (both).

RESULTS: Out of approximately 50,000 women, CBE was found to be the most common screening with an uptake of 95.04% (N =46,897) followed by mammography 74.04% (N = 37,080). It was determined that every age group proved to provide significant results related to screening. A significant higher proportion of Non-Hispanic black (aOR:1.461, 1.161-1.837) were more likely to receive BC screening compared with any other race. Women who are uninsured (aOR:0.485, 0.360-0.652) were 52% less likely to obtain screening compared to women with private insurance. BC screening uptake is also associated with perceived susceptibility & severity i.e. osteoarthritis (aOR:1.392 ,1.039-1.863) and previous BC diagnosis (aOR:3.093, 1.66-5.76). Perceived barriers such as women who drive (aOR: 3.47, 1.47-8.20) were 2 to 2.47 times more likely to obtain BC screening compared to women who depended on other means of transportation.

CONCLUSIONS: Policymakers can use the results of this study to develop guidelines to improve health equity, and establish methods to improve the way screening is performed.