Frazier
EL, Jiles RB, Mayberry R.
Use of screening mammography and clinical breast evaluations among black,
Hispanic, and white women.
Prev Med 1996;25(2):118-25.The authors analyzed data from
22,657 women (2,068 black women, 707 Hispanic women, and 19,882 white women)
who participated in the 1990 Behavioral Risk Factor Surveillance state-based
telephone survey. Using the recommended guidelines of the American Cancer
Society for breast cancer screening, they examined utilization rates by
demographic and selected variables, stratified by ethnic groups. The focus
of the analysis was “to present factors that are common among each
group, not to statistically compare the three groups.”
Racial differences in the incidence and mortality of breast cancer are
reflected in a variety of measures. “The years of potential life
lost before age 65 years from breast cancer were reported as 215 per 100,000
white women and as 253.5 per 100,000 black women. Although the incidence
of breast cancer is 17% lower for black women than for white women, the
5-year survival rate for black women (64%) was 16% lower than the rate
for white women (81%) from 1983 to 1999.”
The authors found that overall rates of mammography use according to
ACS guidelines were similar for black and Hispanic women. “However,
Hispanic women were less likely than whites or blacks to have had a clinical
breast examination according to the guidelines. Calle, et al. reported
similar rates for black and white women of both ever and recent use of
mammography. They also found that Hispanic women appeared to be underserved
regardless of income level. Other studies suggest that race/ethnicity
differences in breast cancer screening procedures are independent of socioeconomic
status.”
“Black women were the least likely to report that their physician
encouraged them to have a mammogram. This finding suggests disparities
in recommendations made by physicians and could account for some of the
racial variations in survival. Breen and Kessler reported that the reason
most often cited for not having had a mammogram was that it was not recommended
by a physician. This finding is also consistent with the report of Grady
and colleagues.”
“The reasons for underutilization of breast cancer screening procedures
are unclear, but may include factors such as access to preventive health
care services, differential recommendations from physicians, an inaccurate
perception of the risk of breast cancer, and the belief that breast cancer
screening examinations are essential only if a lump has been detected.”
