Table 3.
Comparison of diagnostic mammography performance statistics among women being evaluated for a breast lump by race and ethnicity in (2005–2018), adjusted for individual and examination characteristics.
| Model adjustment variablesa,b,c | Sensitivity (modeling probability of a positive mammogram given a cancer) | False-positive rate (modeling probability of false-positive mammogram) | Cancer detection rate (modeling probability of a true positive mammogram) | Invasive cancer detection rate (modeling probability of a true positive [invasive] mammogram) | Short interval follow-up recommendation rate (modeling probability of a BI-RADS 3 assessment) | Biopsy recommendation rate (modeling probability of a positive mammogram) | PPV2 (modeling probability of a true positive given a positive mammogram) |
|---|---|---|---|---|---|---|---|
| (3688 exams with 3459 events) | (51014 exams with 6399 events) | (51014 exams with 3459 events) | (51014 exams with 3237 events) | (51014 exams with 4353 events) | (51014 exams with 9858 events) | (9858 exams with 3459 events) | |
| OR (95% CI) | OR (95% CI) | OR (95% CI) | OR (95% CI) | OR (95% CI) | OR (95% CI) | OR (95% CI) | |
| Unadjusted Model | |||||||
| White | ref | ref | ref | ref | ref | ref | ref |
| Asian/Pacific Islander | 1.77 (1.14, 2.88) | 1.78 (1.66, 1.91) | 1.30 (1.18, 1.43) | 1.21 (1.09, 1.33) | 1.17 (1.06, 1.28) | 1.69 (1.58, 1.79) | 0.78 (0.70, 0.87) |
| Black | 0.91 (0.58, 1.50) | 1.27 (1.14, 1.40) | 1.25 (1.10, 1.42) | 1.23 (1.08, 1.41) | 1.11 (0.98, 1.25) | 1.30 (1.19, 1.41) | 1.00 (0.85, 1.17) |
| Hispanic/Latina | 0.98 (0.53, 2.01) | 1.42 (1.28, 1.57) | 0.63 (0.53, 0.75) | 0.62 (0.51, 0.74) | 0.74 (0.64, 0.85) | 1.12 (1.02, 1.22) | 0.48 (0.39, 0.58) |
| P-valued | (p=0.065) | (p < 0.001) | (p < 0.001) | (p < 0.001) | (p < 0.001) | (p < 0.001) | (p < 0.001) |
| Model 1 e | |||||||
| White | ref | ref | ref | ref | ref | ref | ref |
| Asian/Pacific Islander | 1.32 (0.81, 2.25) | 1.29 (1.19, 1.39) | 1.36 (1.22, 1.51) | 1.29 (1.16, 1.45) | 1.81 (1.63, 2.01) | 1.35 (1.27, 1.45) | 1.09 (0.96, 1.24) |
| Black | 1.36 (0.84, 2.31) | 1.50 (1.34, 1.67) | 1.22 (1.06, 1.40) | 1.18 (1.02, 1.36) | 1.17 (1.02, 1.33) | 1.43 (1.31, 1.57) | 0.80 (0.67, 0.96) |
| Hispanic/Latina | 0.76 (0.40, 1.59) | 1.15 (1.04, 1.27) | 0.64 (0.53, 0.76) | 0.63 (0.52, 0.75) | 0.98 (0.84, 1.13) | 0.96 (0.88, 1.06) | 0.58 (0.47, 0.70) |
| P-value | (p=0.3148) | (p < 0.001) | (p < 0.001) | (p < 0.001) | (p < 0.001) | (p < 0.001) | (p < 0.001) |
| Model 2 f | |||||||
| White | ref | ref | ref | ref | ref | ref | ref |
| Asian/Pacific Islander | 1.36 (0.83, 2.31) | 1.24 (1.15, 1.34) | 1.63 (1.46, 1.81) | 1.55 (1.38, 1.73) | 1.76 (1.58, 1.95) | 1.39 (1.30, 1.49) | 1.33 (1.16, 1.52) |
| Black | 1.43 (0.88, 2.44) | 1.50 (1.34, 1.67) | 1.32 (1.15, 1.52) | 1.28 (1.10, 1.48) | 1.16 (1.02, 1.32) | 1.47 (1.34, 1.61) | 0.86 (0.71, 1.04) |
| Hispanic/Latina | 0.83 (0.44, 1.75) | 1.06 (0.95, 1.17) | 0.86 (0.72, 1.03) | 0.85 (0.71, 1.03) | 0.92 (0.79, 1.07) | 1.01 (0.92, 1.11) | 0.84 (0.67, 1.03) |
| P-value | (p=0.27) | (p < 0.001) | (p < 0.001) | (p < 0.001) | (p < 0.001) | (p < 0.001) | (p < 0.001) |
| Model 11 g | |||||||
| White | ref | ref | ref | ref | ref | ref | ref |
| Asian/Pacific Islander | 1.05 (0.58, 1.99) | 1.11 (1.00, 1.23) | 1.37 (1.18, 1.59) | 1.29 (1.11, 1.50) | 1.66 (1.45, 1.89) | 1.22 (1.12, 1.33) | 1.27 (1.06, 1.53) |
| Black | 1.18 (0.64, 2.27) | 1.56 (1.35, 1.79) | 1.34 (1.11, 1.61) | 1.27 (1.05, 1.53) | 1.17 (0.99, 1.38) | 1.55 (1.37, 1.74) | 0.83 (0.64, 1.06) |
| Hispanic/Latina | 0.61 (0.29, 1.44) | 1.01 (0.89, 1.15) | 0.90 (0.72, 1.11) | 0.89 (0.71, 1.10) | 0.91 (0.75, 1.08) | 0.99 (0.88, 1.10) | 0.84 (0.64, 1.08) |
| P-value | (p=0.62) | (p < 0.001) | (p < 0.001) | (p < 0.001) | (p < 0.001) | (p < 0.001) | (p=0.0048) |
| Model 12 h | |||||||
| White | ref | ref | ref | ref | ref | ref | ref |
| Asian/Pacific Islander | ---i | 1.26 (1.13, 1.40) | 1.66 (1.41, 1.95) | 1.59 (1.34, 1.88) | 0.87 (0.73, 1.04) | 1.44 (1.30, 1.58) | 1.31 (1.07, 1.60) |
| Black | ---i | 1.44 (1.24, 1.68) | 1.26 (1.03, 1.53) | 1.18 (0.96, 1.45) | 1.17 (0.98, 1.40) | 1.42 (1.25, 1.61) | 0.82 (0.63, 1.06) |
| Hispanic/Latina | ---i | 1.05 (0.92, 1.20) | 0.90 (0.72, 1.12) | 0.89 (0.70, 1.11) | 0.95 (0.78, 1.14) | 1.02 (0.90, 1.14) | 0.81 (0.62, 1.06) |
| P-value | (p < 0.001) | (p < 0.001) | (p < 0.001) | (p=0.12) | (p < 0.001) | (p=0.0036) |
Models included observations with non-missing data for each adjustment factor (i.e., number of observations varied by model).
Models 3–10 are shown in Supplementary Table S4
The numbers of exams and events by racial and ethnic group are shown in Supplementary Table S1
Chi-square-based P-value comparing differences across all four groups
Adjusted for mammography registry
Adjusted for mammography registry, age, and age-squared
Adjusted for mammography registry, age, age-squared, rural/urban residence, education, income, family history of breast cancer, breast density, history of breast biopsy, diagnostic mammogram modality, time since last mammogram, and receipt of diagnostic ultrasound or MRI
Adjusted for mammography registry, age, age-squared, rural/urban residence, education, income, family history of breast cancer, breast density, history of breast biopsy, diagnostic mammogram modality, time since last mammogram, receipt of diagnostic ultrasound or MRI, and imaging facility
Could not be computed due to model non-convergence