Abstract
BACKGROUND: Breast cancer is the second leading cause of cancer death among women in the United States. Although the incidence of breast cancer is 13% higher in white women, mortality in black women is 28% higher, due to histological and socioeconomic factors. Existing research regarding racial differences in compliance with breast cancer screening recommendations has found conflicting results. METHODS: Data on more than 4,500 women were taken from the 1992 National Health Interview Survey, a nationally representative, population-based sample survey. Logistic regression was used to estimate the relative odds of knowledge of breast self-exam (BSE) and mammograms, and compliance with BSE, clinical breast exams (CBE), and mammograms. RESULTS: Black women were less likely than white women to be aware of and use breast cancer screening tests. However, among women who were aware of screening tests, compliance was higher among black women. Women with low educational attainment, low cancer knowledge, and no usual source of care were less likely to be CBE or mammogram compliant. Socioeconomic differences were larger for the two clinical tests than for BSE. CONCLUSIONS: Programs should inform women about cancer screening tests and remove barriers that hinder women from receiving clinical screening exams.
Full text
PDFSelected References
These references are in PubMed. This may not be the complete list of references from this article.
- Bankhead C., Richards S. H., Peters T. J., Sharp D. J., Hobbs F. D., Brown J., Roberts L., Tydeman C., Redman V., Formby J. Improving attendance for breast screening among recent non-attenders: a randomised controlled trial of two interventions in primary care. J Med Screen. 2001;8(2):99–105. doi: 10.1136/jms.8.2.99. [DOI] [PubMed] [Google Scholar]
- 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 Jan;84(1):62–67. doi: 10.2105/ajph.84.1.62. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Brewer M. K., Baldwin D. The relationship between self-esteem, health habits, and knowledge of BSE practice in female inmates. Public Health Nurs. 2000 Jan-Feb;17(1):16–24. doi: 10.1046/j.1525-1446.2000.00016.x. [DOI] [PubMed] [Google Scholar]
- Burack R. C., Liang J. The acceptance and completion of mammography by older black women. Am J Public Health. 1989 Jun;79(6):721–726. doi: 10.2105/ajph.79.6.721. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Burns R. B., McCarthy E. P., Freund K. M., Marwill S. L., Shwartz M., Ash A., Moskowitz M. A. Black women receive less mammography even with similar use of primary care. Ann Intern Med. 1996 Aug 1;125(3):173–182. doi: 10.7326/0003-4819-125-3-199608010-00002. [DOI] [PubMed] [Google Scholar]
- Calle E. E., Flanders W. D., Thun M. J., Martin L. M. Demographic predictors of mammography and Pap smear screening in US women. Am J Public Health. 1993 Jan;83(1):53–60. doi: 10.2105/ajph.83.1.53. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Caplan L. S., Wells B. L., Haynes S. Breast cancer screening among older racial/ethnic minorities and whites: barriers to early detection. J Gerontol. 1992 Nov;47(Spec No):101–110. [PubMed] [Google Scholar]
- Carrasquillo O., Himmelstein D. U., Woolhandler S., Bor D. H. Trends in health insurance coverage, 1989-1997. Int J Health Serv. 1999;29(3):467–483. doi: 10.2190/1AV3-E901-TN3D-3H38. [DOI] [PubMed] [Google Scholar]
- Champion V. L. Beliefs about breast cancer and mammography by behavioral stage. Oncol Nurs Forum. 1994 Jul;21(6):1009–1014. [PubMed] [Google Scholar]
- Champion V. L., Menon U., McQuillen D. H., Scott C. Validity of self-reported mammography in low-income African-American women. Am J Prev Med. 1998 Feb;14(2):111–117. doi: 10.1016/s0749-3797(97)00021-4. [DOI] [PubMed] [Google Scholar]
- Champion V., Menon U. Predicting mammography and breast self-examination in African American women. Cancer Nurs. 1997 Oct;20(5):315–322. doi: 10.1097/00002820-199710000-00002. [DOI] [PubMed] [Google Scholar]
- Champion V., Miller A. M. Recent mammography in women aged 35 and older: predisposing variables. Health Care Women Int. 1996 May-Jun;17(3):233–245. doi: 10.1080/07399339609516238. [DOI] [PubMed] [Google Scholar]
- Cornelius L. J. The degree of usual provider continuity for African and Latino Americans. J Health Care Poor Underserved. 1997 May;8(2):170–185. doi: 10.1353/hpu.2010.0247. [DOI] [PubMed] [Google Scholar]
- Danigelis N. L., Roberson N. L., Worden J. K., Flynn B. S., Dorwaldt A. L., Ashley J. A., Skelly J. M., Mickey R. M. Breast screening by African-American women: insights from a household survey and focus groups. Am J Prev Med. 1995 Sep-Oct;11(5):311–317. [PubMed] [Google Scholar]
- Douglass M., Bartolucci A., Waterbor J., Sirles A. Breast cancer early detection: differences between African American and white women's health beliefs and detection practices. Oncol Nurs Forum. 1995 Jun;22(5):835–837. [PubMed] [Google Scholar]
- Douglass M., Bartolucci A., Waterbor J., Sirles A. Breast cancer early detection: differences between African American and white women's health beliefs and detection practices. Oncol Nurs Forum. 1995 Jun;22(5):835–837. [PubMed] [Google Scholar]
- El-Tamer M. B., Homel P., Wait R. B. Is race a poor prognostic factor in breast cancer? J Am Coll Surg. 1999 Jul;189(1):41–45. doi: 10.1016/s1072-7515(99)00055-1. [DOI] [PubMed] [Google Scholar]
- Eley J. W., Hill H. A., Chen V. W., Austin D. F., Wesley M. N., Muss H. B., Greenberg R. S., Coates R. J., Correa P., Redmond C. K. Racial differences in survival from breast cancer. Results of the National Cancer Institute Black/White Cancer Survival Study. JAMA. 1994 Sep 28;272(12):947–954. doi: 10.1001/jama.272.12.947. [DOI] [PubMed] [Google Scholar]
- Fox S. A., Stein J. A. The effect of physician-patient communication on mammography utilization by different ethnic groups. Med Care. 1991 Nov;29(11):1065–1082. doi: 10.1097/00005650-199111000-00001. [DOI] [PubMed] [Google Scholar]
- Foxall M. J., Barron C. R., Houfek J. Ethnic differences in breast self-examination practice and health beliefs. J Adv Nurs. 1998 Feb;27(2):419–428. doi: 10.1046/j.1365-2648.1998.00540.x. [DOI] [PubMed] [Google Scholar]
- Foxall M. J., Barron C. R., Houfek J. Ethnic differences in breast self-examination practice and health beliefs. J Adv Nurs. 1998 Feb;27(2):419–428. doi: 10.1046/j.1365-2648.1998.00540.x. [DOI] [PubMed] [Google Scholar]
- Frazier E. L., Jiles R. B., Mayberry R. Use of screening mammography and clinical breast examinations among black, Hispanic, and white women. Prev Med. 1996 Mar-Apr;25(2):118–125. doi: 10.1006/pmed.1996.0037. [DOI] [PubMed] [Google Scholar]
- Friedman L. C., Webb J. A., Weinberg A. D., Lane M., Cooper H. P., Woodruff A. Breast cancer screening: racial/ethnic differences in behaviors and beliefs. J Cancer Educ. 1995 Winter;10(4):213–216. doi: 10.1080/08858199509528376. [DOI] [PubMed] [Google Scholar]
- Glanz K., Resch N., Lerman C., Blake A., Gorchov P. M., Rimer B. K. Factors associated with adherence to breast cancer screening among working women. J Occup Med. 1992 Nov;34(11):1071–1078. doi: 10.1097/00043764-199211000-00008. [DOI] [PubMed] [Google Scholar]
- Hedegaard H. B., Davidson A. J., Wright R. A. Factors associated with screening mammography in low-income women. Am J Prev Med. 1996 Jan-Feb;12(1):51–56. [PubMed] [Google Scholar]
- Holm C. J., Frank D. I., Curtin J. Health beliefs, health locus of control, and women's mammography behavior. Cancer Nurs. 1999 Apr;22(2):149–156. doi: 10.1097/00002820-199904000-00007. [DOI] [PubMed] [Google Scholar]
- Howard D. L., Penchansky R., Brown M. B. Disaggregating the effects of race on breast cancer survival. Fam Med. 1998 Mar;30(3):228–235. [PubMed] [Google Scholar]
- Hughes C., Lerman C., Lustbader E. Ethnic differences in risk perception among women at increased risk for breast cancer. Breast Cancer Res Treat. 1996;40(1):25–35. doi: 10.1007/BF01806000. [DOI] [PubMed] [Google Scholar]
- Jepson C., Kessler L. G., Portnoy B., Gibbs T. Black-white differences in cancer prevention knowledge and behavior. Am J Public Health. 1991 Apr;81(4):501–504. doi: 10.2105/ajph.81.4.501. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Jones B. A., Kasl S. V., Curnen M. G., Owens P. H., Dubrow R. Can mammography screening explain the race difference in stage at diagnosis of breast cancer? Cancer. 1995 Apr 15;75(8):2103–2113. doi: 10.1002/1097-0142(19950415)75:8<2103::aid-cncr2820750813>3.0.co;2-2. [DOI] [PubMed] [Google Scholar]
- Kelsey J. L., Bernstein L. Epidemiology and prevention of breast cancer. Annu Rev Public Health. 1996;17:47–67. doi: 10.1146/annurev.pu.17.050196.000403. [DOI] [PubMed] [Google Scholar]
- Kuykendall D. H., Johnson M. L., Geraci J. M. Expected source of payment and use of hospital services for coronary atherosclerosis. Med Care. 1995 Jul;33(7):715–728. doi: 10.1097/00005650-199507000-00007. [DOI] [PubMed] [Google Scholar]
- Mandelblatt J., Freeman H., Winczewski D., Cagney K., Williams S., Trowers R., Tang J., Gold K., Lin T. H., Kerner J. The costs and effects of cervical and breast cancer screening in a public hospital emergency room. The Cancer Control Center of Harlem. Am J Public Health. 1997 Jul;87(7):1182–1189. doi: 10.2105/ajph.87.7.1182. [DOI] [PMC free article] [PubMed] [Google Scholar]
- McCarthy B. D., Yood M. U., MacWilliam C. H., Lee M. J. Screening mammography use: the importance of a population perspective. Am J Prev Med. 1996 Mar-Apr;12(2):91–95. [PubMed] [Google Scholar]
- Miller A. M., Champion V. L. Attitudes about breast cancer and mammography: racial, income, and educational differences. Women Health. 1997;26(1):41–63. doi: 10.1300/J013v26n01_04. [DOI] [PubMed] [Google Scholar]
- Miller S. L., Norcross W. A., Bass R. A. Breast self-examination in the primary care setting. J Fam Pract. 1980 May;10(5):811–815. [PubMed] [Google Scholar]
- Monheit A. C., Vistnes J. P. Race/ethnicity and health insurance status: 1987 and 1996. Med Care Res Rev. 2000;57 (Suppl 1):11–35. doi: 10.1177/1077558700057001S02. [DOI] [PubMed] [Google Scholar]
- Moormeier J. Breast cancer in black women. Ann Intern Med. 1996 May 15;124(10):897–905. doi: 10.7326/0003-4819-124-10-199605150-00007. [DOI] [PubMed] [Google Scholar]
- O'Malley A. S., Mandelblatt J., Gold K., Cagney K. A., Kerner J. Continuity of care and the use of breast and cervical cancer screening services in a multiethnic community. Arch Intern Med. 1997 Jul 14;157(13):1462–1470. [PubMed] [Google Scholar]
- O'Malley M. S., Earp J. A., Hawley S. T., Schell M. J., Mathews H. F., Mitchell J. The association of race/ethnicity, socioeconomic status, and physician recommendation for mammography: who gets the message about breast cancer screening? Am J Public Health. 2001 Jan;91(1):49–54. doi: 10.2105/ajph.91.1.49. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Paskett E. D., Tatum C. M., Mack D. W., Hoen H., Case L. D., Velez R. Validation of self-reported breast and cervical cancer screening tests among low-income minority women. Cancer Epidemiol Biomarkers Prev. 1996 Sep;5(9):721–726. [PubMed] [Google Scholar]
- Pearlman D. N., Rakowski W., Ehrich B. Mammography, clinical breast exam, and pap testing: correlates of combined screening. Am J Prev Med. 1996 Jan-Feb;12(1):52–64. [PubMed] [Google Scholar]
- Phillips J. M., Cohen M. Z., Moses G. Breast cancer screening and African American women: fear, fatalism, and silence. Oncol Nurs Forum. 1999 Apr;26(3):561–571. [PubMed] [Google Scholar]
- Phillips J. M., Wilbur J. Adherence to breast cancer screening guidelines among African-American women of differing employment status. Cancer Nurs. 1995 Aug;18(4):258–269. [PubMed] [Google Scholar]
- Powe B. D. Cancer fatalism among African-Americans: a review of the literature. Nurs Outlook. 1996 Jan-Feb;44(1):18–21. doi: 10.1016/s0029-6554(96)80020-0. [DOI] [PubMed] [Google Scholar]
- Powe B. D. Cancer fatalism among elderly Caucasians and African Americans. Oncol Nurs Forum. 1995 Oct;22(9):1355–1359. [PubMed] [Google Scholar]
- Price J. H. Economically disadvantaged females' perceptions of breast cancer and breast cancer screening. J Natl Med Assoc. 1994 Dec;86(12):899–906. [PMC free article] [PubMed] [Google Scholar]
- Qureshi M., Thacker H. L., Litaker D. G., Kippes C. Differences in breast cancer screening rates: an issue of ethnicity or socioeconomics? J Womens Health Gend Based Med. 2000 Nov;9(9):1025–1031. doi: 10.1089/15246090050200060. [DOI] [PubMed] [Google Scholar]
- Reisch L. M., Barton M. B., Fletcher S. W., Kreuter W., Elmore J. G. Breast cancer screening use by African Americans and Whites in an HMO. J Gen Intern Med. 2000 Apr;15(4):229–234. doi: 10.1111/j.1525-1497.2000.01339.x. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Simon M. S., Gimotty P. A., Moncrease A., Dews P., Burack R. C. The effect of patient reminders on the use of screening mammography in an urban health department primary care setting. Breast Cancer Res Treat. 2001 Jan;65(1):63–70. doi: 10.1023/a:1006410711370. [DOI] [PubMed] [Google Scholar]
- Sung J. F., Coates R. J., Williams J. E., Liff J. M., Greenberg R. S., McGrady G. A., Avery B. Y., Blumenthal D. S. Cancer screening intervention among black women in inner-city Atlanta--design of a study. Public Health Rep. 1992 Jul-Aug;107(4):381–388. [PMC free article] [PubMed] [Google Scholar]
- Taylor V. M., Thompson B., Montano D. E., Mahloch J., Johnson K., Li S. Mammography use among women attending an inner-city clinic. J Cancer Educ. 1998 Summer;13(2):96–101. doi: 10.1080/08858199809528524. [DOI] [PubMed] [Google Scholar]
- Weinick R. M., Zuvekas S. H., Cohen J. W. Racial and ethnic differences in access to and use of health care services, 1977 to 1996. Med Care Res Rev. 2000;57 (Suppl 1):36–54. doi: 10.1177/1077558700057001S03. [DOI] [PubMed] [Google Scholar]