Misperceptions hinder screening mammogram compliance

May 26, 2005

Many women skip their annual mammogram because they believe it’s not covered by insurance. They also falsely believe that the test costs more than it does, according to a study published online in May in the journal Cancer.

Many women skip their annual mammogram because they believe it's not covered by insurance. They also falsely believe that the test costs more than it does, according to a study published online in May in the journal Cancer.

Past studies have shown that nearly a quarter of women over 40 have not had a mammogram in the past two years. Approximately 40% of poor women have never had one.

Dr. Ann Scheck McAlearney and colleagues at Ohio State University conducted face-to-face interviews with women over a two-year period to learn why noncompliance was so widespread.

"We were surprised by the proportion of women surveyed who simply had no idea that their insurance covered the cost of a mammogram. Additionally, nearly 40% of the women surveyed said that they had overestimated the costs of a mammogram," said McAlearney, an assistant professor of health services management and policy at OSU.

The researchers asked 897 women over 40 about insurance coverage and probed perceived barriers to mammography screening. They compared the women's reported insurance coverage level with their actual coverage to determine the accuracy of their perceptions.

More than half of the participants reported cost to be the most significant barrier to mammography, but nearly 40% of these women had an inaccurate perception of what their insurance covered.

It remains unknown whether better education efforts on the part of insurance companies and physicians would actually improve the screening rate, McAlearney said.

She suggested the need for a longitudinal cost study in which patients receive information about the true costs of a screening mammogram. Researchers could then determine whether this information makes an actual difference in screening rates.

"We need to see whether this is just an information barrier or an actual cost barrier," she said.

For more information from the online Diagnostic Imaging archives:

Copenhagen study confirms mammo screening benefit

Closing doors in mammography threaten continued access to care

Mammography crisis continues as experts struggle to find solution