Breen N, Kessler L.
Changes in the use of screening mammography: evidence from the 1987 and 1990 National Health Interview Surveys.
Am J Public Health 1994;84(1):62-7.

The authors cross-tabulated and compared data from the 1987 and 1990 National Health Interview Surveys, conducted by the National Center for Health Statistics. In 1987, approximately 17% of women over 40 years of age reported having had a screening mammogram in the previous year. In 1990, the rate doubled. Race declined in importance; income and age remained strong, positive predictors of screening.

“Women who have had a mammogram were likely to be younger and white and to have a higher income, more education, a usual source of health care, and a regular physician.”

“Black and Hispanic women reported having a screening mammography in the previous year less often than White women in 1987. Between 1987 and 1990, however, their rates of use increased more rapidly than did those of White women so that, in 1990, all three racial-ethnic groups reported screening mammography at nearly the same rate. Proportional differences by race and ethnic group were statistically significant in 1987 but not in 1990.”

“Hispanic women reported using mammography screening at the lowest rates of any of the race and ethnic groups under study, yet mammography use increased most among Hispanic women between 1987 and 1990.”

“The trend in the use of breast physical examination reported in the NHIS was analyzed by Makuc, et al., who detected a greater increase in breast exams among Black than White women between 1973 and 1985, resulting in higher rates among Black women in 1985….A larger percentage of Black than White or Hispanic women reported having breast physical examinations in 1987 and 1990, and their rate of screening also increased most. Although rates were lower for White and Hispanic women than for Black women, all three groups showed increased use of breast physical examination.”

“Physicians may fail to recommend mammography if, in their judgment, a woman will not comply or is not able to pay. A study of breast cancer screening use by the Latina community health center clients underscores the importance of providers in initiating discussion and encouraging regular screening…A survey of poor urban Black women found that 85% would have a mammogram if their physician recommended one. Nevertheless, most (63%) physicians queried in 1989 indicated that they did not recommend screening mammography.”