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Research ArticleResearch

Examining screening mammography participation among women aged 40 to 74

Karena D. Volesky and Paul J. Villeneuve
Canadian Family Physician June 2017, 63 (6) e300-e309;
Karena D. Volesky
Doctoral student in the Department of Epidemiology, Biostatistics and Occupational Health at McGill University in Montreal, Que.
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  • For correspondence: karena.volesky@mail.mcgill.ca
Paul J. Villeneuve
Associate Professor in the Department of Health Sciences at Carleton University in Ottawa, Ont.
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    Figure 1.

    Selection of study sample from the 2012 CCHS survey respondents

    CCHS—Canadian Community Health Survey.

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    Table 1.

    Characteristics of women aged 40 to 74 in the CCHS sample and in the Canadian population, 2012: Data for 18 312 women aged 40–74 in the CCHS data set were weighted to represent 7.6 million women in the Canadian population in the same age range in 2012.

    PARTICIPANT CHARACTERISTICSSAMPLE, N (%)*WEIGHTED, N (%)*
    Total18 312 (100.0)7 646 124 (100.0)
    Age group, y
      • 40–493859 (21.1)2 403 118 (31.4)
      • 50–595895 (32.2)2 611 514 (34.2)
      • 60–696310 (34.5)2 005 841 (26.2)
      • 70–742248 (12.3)625 651 (8.2)
    Marital status
      • Single or never married2135 (11.7)721 087 (9.4)
      • Widowed, separated, or divorced5083 (27.8)1 576 884 (20.6)
      • Married or common law11 034 (60.3)5 327 502 (69.7)
      • Missing60 (0.3)20 651 (0.3)
    No. of years since immigration
      • 0–9 y224 (1.2)237 976 (3.1)
      • ≥ 10 y2411 (13.2)1 594 196 (20.9)
      • Not an immigrant15 107 (82.5)5 506 743 (72.0)
      • Missing570 (3.1)307 209 (4.0)
    Educational attainment
      • Less than secondary school2947 (16.1)1 039 957 (13.6)
      • Secondary school graduation4141 (22.6)1 681 850 (22.0)
      • Postsecondary graduation10 594 (57.9)4 633 508 (60.6)
      • Missing630 (3.4)290 809 (3.8)
    Household income
      • < $20 0002328 (12.7)692 930 (9.1)
      • $20 000–$39 9994492 (24.5)1 547 502 (20.2)
      • $40 000–$59 9993729 (20.4)1 449 498 (19.0)
      • $60 000–$79 9992591 (14.2)1 115 459 (14.6)
      •≥ $80 0005156 (28.2)2 838 410 (37.1)
      • Missing16 (< 0.1)2325 (< 0.1)
    Regular doctor
      • No1512 (8.3)613 220 (8.0)
      • Yes16 792 (91.7)7 031 661 (92.0)
      • Missing8 (< 0.1)1243 (< 0.1)
    No. of years since last physical checkup
      • > 2 y2328 (12.7)1 374 036 (18.0)
      • 1–2 y1255 (6.9)1 540 249 (20.1)
      • < 1 y12 502 (68.3)3 871 929 (50.6)
      • Missing2227 (12.2)859 910 (11.3)
    No. of years since last Papanicolaou test
      • > 5 y3952 (21.6)1 310 732 (17.1)
      • 3–5 y1382 (7.6)503 794 (6.6)
      • < 3 y11 275 (61.6)5 053 922 (66.1)
      • Missing1703 (9.3)186 553 (10.2)
    BMI category
      • Obese (≥ 30.0 kg/m2)4198 (22.9)1 547 640 (20.2)
      • Overweight (25.0–29.9 kg/m2)5464 (29.8)2 166 713 (28.3)
      • Normal weight (18.5–24.9 kg/m2)7302 (39.9)3 378 774 (44.2)
      • Underweight (< 18.5 kg/m2)367 (2.0)166 912 (2.2)
      • Missing981 (5.4)386 085 (5.1)
    Frequency of alcohol consumption
      •≥ 4 times per wk3396 (18.5)903 859 (11.8)
      • 1–3 times per wk4849 (26.5)2 012 753 (26.3)
      • < 3 times per mo to < once per mo3717 (20.3)2 731 194 (35.7)
      • Missing6350 (34.7)1 998 318 (26.1)
    Smoking status
      • Daily3016 (16.5)1 120 110 (14.7)
      • Occasionally584 (3.2)270 329 (3.5)
      • Not at all14 633 (79.9)6 209 718 (81.2)
      • Missing79 (0.4)45 967 (0.6)
    • BMI—body mass index, CCHS—Canadian Community Health Survey.

    • ↵* Not all percentages add to 100 owing to rounding.

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    Table 2.

    Mammography participation among Canadian women by age group, 2012: Data for 16 858 women aged 40–74 in the CCHS data set were weighted to represent 7.1 million women in the Canadian population in the same age range in 2012.

    MAMMOGRAPHY PARTICIPATIONAGE GROUPS, N (%)*TOTAL, N (%)
    40–49 Y50–59 Y60–69 Y70–74 Y
    Have ever had mammogram1 265 539 (52.9)2 284 727 (88.4)1 874 475 (94.6)574 943 (94.3)5 999 684 (79.3)
    Had mammogram < 2 y ago899 171 (37.6)1 765 104 (68.9)1 508 586 (76.5)390 822 (64.8)4 563 683 (60.6)
    Had mammogram 2 to < 5 y ago213 677 (8.9)345 055 (13.5)193 202 (9.8)101 773 (16.9)853 707 (11.3)
    Had mammogram for diagnostic reasons†309 860 (12.9)270 928 (10.5)181 812 (9.2)58 351 (9.6)820 951 (10.8)
    Had mammogram for screening reasons†958 705 (40.1)2 041 901 (79.0)1 715 677 (86.6)513 391 (84.2)5 229 674 (69.1)
    Had mammogram < 2 y ago for screening reasons†750 060 (31.4)1 623 962 (63.4)1 385 467 (70.3)352 167 (58.4)4 111 656 (54.6)
    • CCHS—Canadian Community Health Survey.

    • ↵* Women whose responses were “don’t know,” “refused,” or “not stated” to the questions asking if they ever had a mammogram and when was the last time they had a mammogram were excluded.

    • ↵† Previously detected lump and follow-up of breast cancer were coded as diagnostic reasons for mammograms. Women who indicated their age, having regular checkup or routine screening, having family history of breast cancer, or using hormone replacement therapy as reasons for having a mammogram were considered screening participants.

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    Table 3.

    Screening mammography participation among Canadian women by age group and region, 2012: Data for 16 858 women aged 40–74 in the CCHS data set were weighted to represent 7.1 million women in the Canadian population in the same age range in 2012.

    REGIONAGE GROUPS OF SCREENING MAMMOGRAPHY PARTICIPANTS, N (%)*†TOTAL
    40–49 Y50–59 Y60–69 Y70–74 Y
    Ontario307 030 (30.8)623 259 (64.3)570 336 (74.2)139 998 (64.1)1 640 623 (55.5)
    British Columbia139 471 (41.1)201 185 (61.1)198 473 (68.2)42 132 (58.7)581 261 (56.3)
    Alberta100 845 (45.8)183 152 (66.5)122 969 (69.2)31 635 (62.7)438 601 (60.6)
    Saskatchewan13 960 (25.0)45 015 (59.7)30 358 (58.4)9082 (49.7)98 415 (48.8)
    Manitoba26 178 (30.5)58 124 (65.6)41 908 (70.6)12 961 (56.5)139 171 (54.2)
    Quebec97 468 (18.9)389 201 (63.1)313 743 (69.4)89 662 (52.5)890 074 (50.7)
    New Brunswick11 712 (22.3)38 824 (61.3)35 839 (67.2)8741 (51.7)95 116 (51.1)
    Nova Scotia29 581 (45.2)51 001 (60.1)36 135 (58.9)11 337 (50.4)128 054 (54.7)
    Prince Edward Island5629 (56.1)6221 (54.0)6125 (52.8)1871 (65.2)19 846 (55.1)
    Newfoundland and Labrador15 914 (42.6)24 399 (59.8)27 843 (68.9)4609 (57.8)72 765 (57.5)
    Territories2273 (31.4)3582 (55.2)1739 (49.2)138 (35.4)7732 (43.8)
    • CCHS—Canadian Community Health Survey.

    • ↵* Women whose responses were “don’t know,” “refused,” or “not stated” to the questions asking if they ever had a mammogram and when was the last time they had a mammogram were excluded.

    • ↵† Women who reported that they had had a mammogram less than 2 y ago and selected age, having regular checkups or routine screening, having family history of breast cancer, or using hormone replacement therapy as reasons for having a mammogram were considered screening participants.

    • View popup
    Table 4.

    Odds ratios for select characteristics for CCHS sample of women aged 40–74 who were screening mammography participants, 2012

    PARTICIPANT CHARACTERISTICS*SCREENING MAMMOGRAPHY PARTICIPATION†UNADJUSTED OR (95% CI)‡ADJUSTED OR (95% CI)‡‖
    SAMPLE, %‡WEIGHTED, %§
    Age group, y
      • 40–4929.131.4ReferenceReference
      • 50–5963.963.44.79 (4.37–5.24)5.11 (4.65–5.60)
      • 60–6969.470.36.48 (5.91–7.11)7.61 (6.89–8.40)
      • 70–7457.958.43.62 (3.23–4.05)4.53 (4.01–5.13)
    Marital status
      • Never married47.641.3ReferenceReference
      • Widowed, separated, or divorced56.854.51.54 (1.39–1.71)1.06 (0.95–1.19)
      • Married or common law60.156.51.77 (1.61–1.95)1.27 (1.14–1.42)
    No. of years since immigration
      • 0–9 y34.143.7ReferenceReference
      • ≥ 10 y59.958.43.10 (2.23–4.19)1.48 (1.07–2.05)
      • Not an immigrant57.954.32.91 (2.18–3.88)1.43 (1.04–1.96)
    Educational attainment
      • Less than secondary school55.554.1ReferenceReference
      • Secondary school graduation59.454.31.17 (1.05–1.29)1.19 (1.06–1.33)
      • Postsecondary graduation57.855.11.07 (0.98–1.17)1.24 (1.12–1.37)
    Household income
      • < $20 00050.047.6ReferenceReference
      • $20 000–$39 99957.954.51.40 (1.26–1.56)1.31 (1.17–1.46)
      • $40 000–$59 99959.656.81.51 (1.35–1.69)1.50 (1.33–1.69)
      • $60 000–$79 99960.153.01.53 (1.36–1.73)1.69 (1.47–1.93)
      • ≥ $80 00058.455.91.42 (1.28–1.57)1.96 (1.73–2.22)
    Regular doctor
      • No32.628.5ReferenceReference
      • Yes59.956.93.37 (3.00–3.77)3.30 (2.90–3.73)
    No. of years since last physical checkup
      • > 2 y39.032.0ReferenceReference
      • 1–2 y61.958.42.74 (2.10–3.59)2.40 (1.80–3.22)
      • < 1 y66.864.52.07 (1.58–2.72)3.06 (2.30–4.08)
    No. of years since last Papanicolaou test
      • > 5 y47.742.2ReferenceReference
      • 3–5 y46.943.80.96 (0.85–1.09)1.11 (0.97–1.26)
      • < 3 y64.360.82.15 (1.99–2.33)3.47 (3.18–3.79)
    BMI category
      • Obese (≥ 30.0 kg/m2)57.954.3ReferenceReference
      • Overweight (25.0–29.9 kg/m2)61.257.81.18 (1.08–1.28)1.09 (0.99–1.19)
      • Normal weight (18.5–24.9 kg/m2)56.154.00.93 (0.85–1.00)0.96 (0.88–1.05)
      • Underweight (< 18.5 kg/m2)45.137.60.58 (0.47–0.73)0.63 (0.50–0.81)
    Frequency of alcohol consumption
      • ≥ 4 times per wk63.957.7ReferenceReference
      • 1–3 times per wk60.355.00.85 (0.76–0.96)1.06 (0.94–1.20)
      • < 3 times per mo56.454.30.71 (0.64–0.79)0.90 (0.80–1.01)
    Smoking status
      • Daily45.544.5ReferenceReference
      • Occasionally51.646.71.32 (1.10–1.59)1.41 (1.16–1.73)
      • Not at all60.456.81.92 (1.77–2.09)1.73 (1.59–1.90)
    Region
      • Ontario59.255.5ReferenceReference
      • British Columbia59.156.30.99 (0.89–1.10)1.02 (0.91–1.14)
      • Alberta62.060.61.14 (1.01–1.29)1.12 (0.98–1.27)
      • Saskatchewan51.848.80.74 (0.64–0.85)0.71 (0.61–0.83)
      • Manitoba54.554.20.81 (0.71–0.94)0.78 (0.67–0.91)
      • Quebec56.250.70.93 (0.85–1.02)0.97 (0.88–1.07)
      • New Brunswick56.551.10.97 (0.83–1.14)0.98 (0.83–1.16)
      • Nova Scotia55.754.70.88 (0.75–1.04)0.90 (0.76–1.07)
      • Prince Edward Island59.055.10.98 (0.76–1.28)0.95 (0.72–1.26)
      • Newfoundland and Labrador59.957.51.14 (0.95–1.38)1.17 (0.96–1.43)
      • Territories43.043.80.51 (0.40–0.65)0.60 (0.46–0.78)
    • BMI—body mass index, CCHS—Canadian Community Health Survey, OR—odds ratio.

    • ↵* Women who reported that they had had a mammogram less than 2 y ago and selected age, having regular checkups or routine screening, having family history of breast cancer, or using hormone replacement therapy as reasons for having a mammogram were considered screening participants.

    • ↵† Women whose responses were “don’t know,” “refused,” or “not stated” to the questions asking if they ever had a mammogram and when was the last time they had a mammogram were excluded.

    • ↵‡ Data for 16 858 women aged 40–74 in the 2012 CCHS data set.

    • ↵§ Data for 16 858 women aged 40–74 weighted to represent 7.1 million women aged 40–74 in the same age range.

    • ↵‖ Adjusted for age, marital status, and household income.

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Canadian Family Physician: 63 (6)
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Examining screening mammography participation among women aged 40 to 74
Karena D. Volesky, Paul J. Villeneuve
Canadian Family Physician Jun 2017, 63 (6) e300-e309;

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