Association of depression with adherence to breast cancer screening among women aged 50 to 74 years in the United States

Rationale, aims, and objectives: Previous research has shown inconsistent results regarding the association of depression and screening mammography use behaviours. This study aimed to assess the relationship between women's depression and mammography adherence. Methods: This cross-sectional study used data from the 2016 Behavioural Risk Factor Surveillance System and employed the Health Belief Model (HBM). The primary independent variable was the presence of depression. The dependent variable was adherence to biennial screening mammography based on the US Preventive Services Task Force guidelines. Demographic characteristics and HBM constructs were included as covariates. Univariate and multivariate logistic regressions were used. Results: A total of 139 550 women were included (weighted n = 48 712 531). Among them, 23.1% reported the presence of depression (n = 32 247). The unadjusted odds ratio (OR) for mammography use in women with depression was 0.85 (95% confidence interval [CI], 0.80-0.91, P <.001) compared with women without depression, and the probability of mammography use was significantly lower in women with depression (76.3%; 95% CI, 75.4-77.3) compared with women without depression (79.1%; 95% CI, 78.5-79.6). However, the adjusted OR was not statistically significant when controlling for demographic and HBM characteristics (1.02; 95% CI, 0.93-1.11, P =.698), and the probabilities of mammography use were similar between women with depression (80.1%; 95% CI, 79.0-81.3) and without depression (79.9%; 95% CI, 79.2-80.6). Conclusions: Depression itself was related to nonadherence with mammography screening guidelines. However, after controlling for demographic and HBM characteristics, depression was not associated with adherence with mammography screening guidelines.