Self-reported mental well-being as a predictor of utilization and compliance to mammography screening

Purpose: The purpose of this study was to examine self-reported mental well-being as a predictor of mammography utilization and compliance in a nationally representative sample in the United States. Mental health status and diagnosed mental disorders have been studied as barriers to cancer screening. Little research has focused on the non-diagnosed mental health experiences of women and its relationship to mammography.

Methods: The data were extracted from the 2010 BRFSS and the sample included women aged 42 and over. Compliance was determined using the American Cancer Society's recommendations of yearly mammography for women 40 and over. Mental well-being was assessed using items in the BRFSS that asked about the number of days the women felt depressed, anxious, or stressed in the last 30 days and categorized as zero, low, high or very high. Demographic variables were also extracted to assess any differences across race/ethnicity, age, marital status, insurance status, etc.

Results: Poor mental well-being was negatively and significantly associated with ever use and recent use (as an indicator of compliance). Women who indicated experiencing 14 or more days of anxiety or stress were less likely to be compliant with mammography recommendations. Significant differences were found between racial/ethnic groups when mental well-being was included in the model. Older women experienced higher rates of poor mental well-being and were less likely compliant to mammography recommendations.

Conclusion: Mental well-being, which is experienced by more than 50% of the population, has a significant impact on mammography. Addressing these issues may increase cancer screening efforts.