Mammography Screening Practices in Average-Risk Women Aged 40-49 Years in Primary Care: A Comparison of Physician and Nonphysician Providers in Minnesota

Katherine Martin, Rachel I. Vogel, Rebekah H. Nagler, Jean F. Wyman, Nancy Raymond, Deanna Teoh, Alicia M. Allen, Kristine M.C. Talley, Susan Mason, Anne H. Blaes

Research output: Contribution to journalArticlepeer-review

3 Scopus citations


Background: Breast cancer screening practices and the influence of clinical guidelines or recommendations are well documented for physicians, but little is known about the screening practices of nonphysician providers (physician assistants and advanced practice registered nurses). The seven breast cancer screening guidelines or recommendations on the use of mammography have the most variation for screening average-risk women 40-49 years of age. Therefore, to better understand the practices of nonphysicians, this study will compare the practices of physicians with nonphysician providers for women 40-49 years of age. Materials and Methods: Minnesota physicians and nonphysicians were e-mailed an anonymous cross-sectional survey, which asked primary care providers about their mammography screening practices for average-risk women 40-44 and 45-49 years of age and to rate the influence of seven breast cancer screening recommendations on the use of mammography in their practice. Comparisons across providers' demographic and professional characteristics were conducted using chi-squared and Fisher's exact tests, as appropriate, and multivariate logistic regression analyses. Results: Of the respondents who practiced primary care (193 physicians, 50 physician assistants, and 197 advanced practice registered nurses), 66.7% reported recommending mammography for women at ages 40-44 and 77.2% recommended mammography for women at ages 45-49. Nonphysician providers were more likely to recommend screening in both these age groups ( p  < 0.05). Having a self-identified interest in women's health was associated with more mammography screening in both age groups. The American Cancer Society guideline was endorsed as influential by the most respondents. Conclusions: Breast cancer screening practices vary between physicians and nonphysician providers for women 40-49 years of age at average risk. Targeted interventions may help reduce practice variation and ensure high-value care.

Original languageEnglish (US)
Pages (from-to)91-99
Number of pages9
JournalJournal of Women's Health
Issue number1
StatePublished - Jan 2020

Bibliographical note

Funding Information:
Research reported in this publication was supported by the Eunice Kennedy Shriver National Institute of Child Health and Human Development of the National Institutes of Health under award number K12HD055887 and the Deborah E. Powell Center for Women’s Health at the University of Minnesota Medical School. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.

Publisher Copyright:
© Mary Ann Liebert, Inc., publishers 2020.


  • breast cancer
  • cancer screening recommendations
  • health care providers
  • mammography screening
  • practice patterns
  • Attitude of Health Personnel
  • Breast Neoplasms/diagnostic imaging
  • Practice Patterns, Physicians'/statistics & numerical data
  • Guideline Adherence/statistics & numerical data
  • Cross-Sectional Studies
  • Physicians
  • Humans
  • Mass Screening/standards
  • Middle Aged
  • Minnesota
  • Early Detection of Cancer/statistics & numerical data
  • Mammography/statistics & numerical data
  • Health Personnel
  • Adult
  • Female
  • Primary Health Care

PubMed: MeSH publication types

  • Research Support, Non-U.S. Gov't
  • Journal Article
  • Research Support, N.I.H., Extramural


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