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A F Saunders

Publications and source records attributed to A F Saunders.

4 recordsLinked to original sources
PubMed1992

Physician-related barriers to breast cancer screening in older women.

Despite evidence that annual mammographic screening in women 50 years and older reduces mortality, surveys of physicians and patients have repeatedly demonstrated that annual screening mammography is not performed. The fundamental question addressed in this chapter is: If the assumption is made that the scientific evidence supports the use of mammography, what, then, are physician-related barriers to mammographic screening of elderly women? Using a model that classifies barriers to implementing prevention protocols into three categories (predisposing, enabling, and reinforcing factors), literature is reviewed to help identify reasons for low mammographic screening rates, especially in elderly women. This article concludes with a discussion of strategies that may help overcome barriers to mammographic screening in elderly women.

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PubMed1991

Breast cancer screening in older women: practices and barriers reported by primary care physicians.

Annual mammography, in combination with clinical breast examinations, can reduce mortality from breast cancer. However, surveys of both patients and physicians suggest that mammography is underutilized. This study examined whether physicians' reported breast cancer screening practices and barriers to mammography varied with patients' age. Data from 576 primary care physicians (internal medicine, family/general practice, and obstetrics/gynecology) who participated in a mailed statewide survey were analyzed. Physicians reported screening elderly women significantly less often than younger women, regardless of family history of breast cancer. With the exception of medical specialty, physicians' demographic and practice characteristics were not associated with reported screening practices. However, physicians' knowledge and beliefs about breast cancer in older women were associated with reported screening practices. When analyzing barriers to ordering mammography, cost to the patient was viewed as a barrier for women of all ages, and pain was viewed as a greater barrier for younger women; otherwise, physicians consistently believed that their elderly patients faced considerably more barriers compared with younger women. Further investigation is required to examine why primary care physicians report age-related differences in both breast screening and barriers to mammography.

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PubMedDate not supplied

Physicians' awareness of mammography charges.

Although physicians commonly report cost as a barrier to screening mammography, their awareness of mammography charges is unknown. Using a statewide sample, we assessed accuracy of primary care physicians' estimates of mammography charges among 506 eligible physicians who returned questionnaires. Differences between estimated charges and actual charges at their mammography referral facilities were small (mean = $2.74, median = 0) and unrelated to physicians' specialty, age, gender, or practice type. We conclude that physicians are cognizant of mammography charges. Overestimates in charges may not explain low mammographic screening rates.

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