Is Female Caregivers' Mammogram Screening Behavior Associated with Hours of Caregiving?: Comparison with Non-Caregivers

Background and Purpose:Mammogram Screening is very crucial for women to prevent and detect breast cancer. The latest American Cancer Society breast cancer screening guidelines recommends that “all women should begin having yearly mammograms by age 45, and can change to having mammograms every other year beginning at age 55”. Delay in getting recommended mammograms is one of the recognized unmet health care needs of female caregivers. Caregiving responsibilities significantly impact  females’ decisions on adhering to preventive mammography. In current literature, the roles of caregiving related factors on females’ mammogram screening behavior remain unclear. This study aims to examine the relation between mammogram screening behavior and hours of caregiving comparing with caregiver and non-caregiver group. The purpose of this study is to compare mammogram screening behaviors between caregivers and non-caregivers to examine (1) the levels of Mammogram receipt, (2) the role of caregiving factors,and (3) the role of cancer beliefs on Mammogram screeningof caregivers and non-caregivers.

Methods: The 2017Health Information National Trends Survey (HINTS) provides samples of women aged from 40 to 75 years old for this secondary analysis. The samples werecategorized into two subgroups: caregivers and non-caregivers. By using Andersen’s Behavioral Model of Health Services Use, we estimated a binomial logistic regression model that included predisposing factors, enabling factors, and need factors as independent variables and a dichotomous indicator of mammogram screening uptake as the dependent variable. All analyses incorporated replicated sampling weights provided by HINTS to generate unbiased estimates and were conducted using Stata 12.0 software package.

Results:  Mammogram screening associated positively with age (OR = 1.058, p< 0.001, OR = 1.029, p< 0.000) and negatively with the term “rather not know my likelihood of getting cancer” (OR = .673, p< 0.05, OR = .825, p< 0.01) for both groups. However, the dependent variable was positively associated with feeling confident in obtaining health information (OR = 1.432, p< 0.05) and believing cancer is more common than heart disease (OR = 1.490, p< 0.05) and negatively associated withcaregiving hours per week (OR = .749, p< 0.05) only among the caregiving group. For the non-caregiver group, the dependent variable was positively associated with how worried they were about getting cancer (OR = 1.156, p< 0.05) and negatively associated with depression (OR = .919, p< 0.001).

Conclusions and Implications: Burden of caregiving is a critical barrier of mammography screening. Caregivers who have many caregiving tasks and havelonger hours of caregiving have less frequent breast examinations. To support caregivers’ breast cancer prevention, social workers should advocate for caregiving-related policies and develop practical cancer preventioninterventions. Particularly, effort to promote breast cancer screening education and care support among older primary caregivers will likely increase their adherence to preventive mammography uptake.