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Breast cancer screening and ethnicity in the United States: implications for health disparities research

  • Epidemiology
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Abstract

Ethnic and racial minority women within the U.S. are less likely to use breast cancer screening (BCS) procedures than non-Latina White women, and are more likely to be diagnosed with cancer at later stages of disease. Previous studies examining Latina rates of screening and disease have used aggregated populations for comparison, possibly attenuating important ethnic healthcare disparities and yielding misleading findings. The purpose of this study was to examine if ethnicity matters in understanding current estimates of BCS patterns among U.S. women; to test if healthcare disparities in BCS are present, and if any ethnic/racial groups are primarily affected. The authors used multivariate multinomial regression to examine self-reported mammogram and clinical breast exam in the 2007 full-year U.S. Medical Expenditure Panel Survey. Mexican origin women reported the lowest rates of past-year mammograms and clinical breast examination. Factors enabling healthcare moderated the group’s lower likelihood of mammograms and clinical breast examination. Some breast cancer screening parity appears to have been achieved in 2007 for Black and some Latina groups; however, those rates lag behind for the largest Latino ethnic group, Mexican. Factors enabling healthcare access, such as education, income and insurance, attenuated the BCS inequalities found for Mexican origin women. Findings suggest that successful efforts to reduce BCS disparities be strategically redirected to include women of Mexican origin in addition to other underserved populations.

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References

  1. Mathers C, Loncar D (2006) Projections of global mortality and burden of disease from 2002 to 2030. PLoS Med 3(11):e442

    Article  PubMed  Google Scholar 

  2. Mandelblatt JS, Cronin KA, Bailey S, Berry DA, de Koning HJ, Draisma G, Huang H, Lee SJ, Munsell M, Plevritis SK et al (2009) Effects of mammography screening under different screening schedules: model estimates of potential benefits and harms. Ann Intern Med 151(10):738–747

    PubMed  Google Scholar 

  3. Coughlin SS, Uhler RJ, Richards T, Wilson KM (2003) Breast and cervical cancer screening practices among Hispanic and non-Hispanic women residing near the United States-Mexico border, 1999–2000. Family community health 26(2):130–139

    PubMed  Google Scholar 

  4. Jones AR, Caplan LS, Davis MK (2003) Racial/ethnic differences in the self-reported use of screening mammography. J Community Health 28(5):301–316

    Article  Google Scholar 

  5. Rodriguez MA, Ward LM, Perez-Stable EJ (2005) Breast and cervical cancer screening: impact of health insurance status, ethnicity, and nativity of Latinas. Annal Family Med 3(3):235–241

    Article  Google Scholar 

  6. Lantz PM, Mujahid M, Schwartz K, Janz NK, Fagerlin A, Salem B, Liu L, Deapen D, Katz SJ (2006) The influence of race, ethnicity, and individual socioeconomic factors on breast cancer stage at diagnosis. Am J Public Health 96(12):2173–2178

    Article  PubMed  Google Scholar 

  7. Abraido-Lanza AF, Chao MT, Gammon MD (2004) Breast and cervical cancer screening among Latinas and non-Latina whites. Am J Public Health 94(8):1393–1398

    Article  PubMed  Google Scholar 

  8. Kagawa-Singer M, Dadia AV, Yu MC, Surbone A (2010) Cancer, culture, and health disparities: time to chart a new course? CA Cancer J Clinic 60(1):12–39

    Article  Google Scholar 

  9. Rodriguez MA, Ward LM, Perez-Stable EJ (2005) Breast and cervical cancer screening: impact of health insurance status, ethnicity, and nativity of Latinas. Annal Family Med 3(3):235–241

    Article  Google Scholar 

  10. González HM, Vega WA, Williams DR, Tarraf W, West BT, Neighbors HW (2010) Depression care in the United States: too little for too few. Arch Gen Psychiatry 67(1):37–46

    Article  PubMed  Google Scholar 

  11. González HM, Vega WA, Rodriguez MA, Tarraf W, Sribney WM (2009) Diabetes awareness and knowledge among Latinos: does a usual source of healthcare matter? J Gen Intern Med 24(Suppl 3):528–533

    Article  PubMed  Google Scholar 

  12. Alegria M, Chatterji P, Wells K, Cao Z, Chen CN, Takeuchi D, Jackson J, Meng XL (2008) Disparity in depression treatment among racial and ethnic minority populations in the United States. Psychiatr Serv 59(11):1264–1272

    Article  PubMed  Google Scholar 

  13. Census: American Community Survey, 2008

  14. U.S. Census Bureau (2004) Table 1a. Projected population of the United States, by race and hispanic origin: 2000 to 2050

  15. Current Population Series (2007) In: Bureau USC (ed), vol. 15. Washington, U.S. Government Printing Office

  16. Peek ME, Han JH (2004) Disparities in screening mammography: current status, interventions, and implications. J Gen Intern Med 19(2):184–194

    PubMed  Google Scholar 

  17. Io M (2003) Unequal treatment: confronting racial and ethnic disparities in healthcare. The National Academies, Washington

    Google Scholar 

  18. Andersen RM (1995) Revisiting the behavioral model and access to medical care: does it matter? J Health Soc Behav 36(1):1–10

    Article  PubMed  CAS  Google Scholar 

  19. Medical expenditure panel survey (2007) In: agency for healthcare research and quality

  20. Ezzati-Rice T, Rohde F, Greenblatt J (2008) Sample design of the medical expenditure panel survey household component, 1998–2007

  21. Nelson HD, Tyne K, Naik A, Bougatsos C, Chan BK, Humphrey L (2009) Screening for breast cancer: an update for the U.S. preventive services task force. Ann Intern Med 151(10):727–737

    PubMed  Google Scholar 

  22. USPSTF (2002) Screening for breast cancer: recommendations and rationale. Ann Intern Med 137:344–346

    Google Scholar 

  23. USPSTF (2009) Screening for breast cancer: U.S. preventive services task force recommendation statement. Ann Intern Med 151:716–726

    Google Scholar 

  24. Cancer Facts & Figures (2009) In: Atlanta: American Cancer Society

  25. Lee ES, Forthofer RN (2005) Analyzing complex survey data (Quantitative applications in the social sciences). Sage Publications, Newbury Park

    Google Scholar 

  26. Cochran WG (1977) Sampling Techniques, 3rd edn. Wiley, New York

    Google Scholar 

  27. James C, Thomas M, Lillie-Blanton M, Garfield R (2007) Key facts: race, ethnicity & medical care

  28. U.S. Department of Education (2009) Status dropout rates of 16- through 24-year-olds, by race/ethnicity: selected years, 1980–2007, Washington

  29. Bustamante AV, Chen J, Rodriguez HP, Rizzo JA, Ortega AN (2010) Use of preventive care services among Latino subgroups. American J Prev Med 38(6):610–619

    Article  Google Scholar 

  30. Sheinfeld Gorin S, Heck JE (2005) Cancer screening among Latino subgroups in the United States. Prev Med 40(5):515–526

    Article  Google Scholar 

  31. Zambrana RE, Breen N, Fox SA, Gutierrez-Mohamed ML (1999) Use of cancer screening practices by Hispanic women: analyses by subgroup. Prev Med 29(6 I):466–477

    Article  PubMed  CAS  Google Scholar 

  32. Mandelblatt JS, Cronin KA, Bailey S, Berry DA, de Koning HJ, Draisma G, Huang H, Lee SJ, Munsell M, Plevritis SK, Ravdin P, Schechter CB, Sigal B, Stoto MA, Stout NK, van Ravesteyn NT, Venier J, Zclen M, Feuer EJ: Breast Cancer Working Group of the Cancer Intervention and Surveillance Modeling Network. Effects of mammography screening under different screening schedules: Model estimates of potential benefits and harms (Annals of Internal Medicine (2009) 151 (738-747)). Annals of Internal Medicine 152(2):136

  33. Altekruse SF, Kosary CL, Krapcho M, Neyman N, Aminou R, Waldron W, Ruhl J, Howlader N, Tatalovich Z, Cho H et al. Bethesda (eds) (2010) SEER Cancer Statistics Review 1975–2007

  34. Fiscella K, Franks P, Meldrum S (2004) Estimating racial/ethnic disparity in mammography rates: it all depends on how you ask the question. Prev Med 39(2):399–403

    Article  PubMed  Google Scholar 

  35. Cronin KA, Miglioretti DL, Krapcho M, Yu B, Geller BM, Carney PA, Onega T, Feuer EJ, Breen N, Ballard-Barbash R (2009) Bias associated with self-report of prior screening mammography. Cancer Epidemiol Biomarkers Prev 18(6):1699–1705

    Article  PubMed  Google Scholar 

  36. Craig BM, Quinn GP, Vadaparampil ST (2009) Sensitivity of self-report mammography use in older women. Am J Prev Med 37(5):441–444

    Article  PubMed  Google Scholar 

  37. Miranda PY, Wilkinson AV, Etzel C, Zhou R, Jones LA, Thompson P, Bondy M (2011) Policy implications of early onset breast cancer among Mexican-origin women. Cancer 117:390–397

    Google Scholar 

Download references

Acknowledgments

This study was supported by the Kellogg Health Scholars Program under a grant from the W.K. Kellogg Foundation to the Center for Advancing Health (P0117943) while PYM was a Kellogg Health Scholar Postdoctoral Fellow at the University of Texas M.D. Anderson Cancer, Center for Research on Minority Health, and from the National Institute of Mental Health (MH 84994 to HMG).

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Authors and Affiliations

  1. Department of Health Policy and Administration, The Pennsylvania State University, 601G Ford Building, University Park, PA, 16802, USA

    Patricia Y. Miranda

  2. Department of Family Medicine and Public Health Sciences, Institute of Gerontology, Wayne State University, 87 East Ferry Street, 234 Knapp Building, Detroit, MI, 48202, USA

    Wassim Tarraf & Hector M. González

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  1. Patricia Y. Miranda
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  2. Wassim Tarraf
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  3. Hector M. González
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Correspondence to Hector M. González.

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Miranda, P.Y., Tarraf, W. & González, H.M. Breast cancer screening and ethnicity in the United States: implications for health disparities research. Breast Cancer Res Treat 128, 535–542 (2011). https://doi.org/10.1007/s10549-011-1367-8

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  • DOI: https://doi.org/10.1007/s10549-011-1367-8

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