Prevalence and Determinants of Mammography Use among Women Aged 40 to 49 Years in the United States

BACKGROUND: There are limited data on mammography use patterns and determinants among women aged <50 years in the United States. We, therefore, estimated mammography use and key determinants among US women aged 40 to 49 years, as well as geospatial variations in mammography use patterns. METHODS: We analyzed data from the 2022 Behavioral Risk Factor Surveillance System to estimate mammography use within the prior 2 years. We applied a weighted logistic regression model to determine factors associated with mammography use. Multiscale geographically weighted regression was performed to understand the spatial context of mammography use. RESULTS: The weighted prevalence of mammography use was 59.1% [95% confidence interval (CI), 57.9-60.3], with a higher prevalence in urban [59.2% (95% CI, 57.9-60.5)] than in rural areas [54.1% (95% CI, 49.5-58.6)]. Non-Hispanic Black women had higher odds of mammography use than non-Hispanic White women [OR = 1.30 (95% CI, 1.10-1.54)], whereas Asian women had lower odds [OR = 0.62 (95% CI, 0.43-0.89)]. Women with multiple healthcare providers [OR = 2.90 (95% CI, 2.36-3.57)] and those with private insurance [OR = 1.96 (95% CI, 1.45-2.65)] had higher odds of mammography use. Other key factors included healthcare affordability, smoking, and marital status. Spatially, barriers to healthcare access were associated with mammography use, particularly in the West, Midwest, and Southwest regions. CONCLUSIONS: Mammography use was significantly shaped by healthcare access, race, smoking, and marital status, highlighting important socioeconomic, healthcare, and behavioral influences. IMPACT: Understanding the variations and key determinants of mammography use can inform and tailor more effective breast cancer screening strategies.