Study: Minorities less likely to be screened

Researchers hope the survey can generate more targeted screening for minorities.
KNIGHT RIDDER NEWSPAPERS
SAN JOSE, Calif. -- Women of color are less likely than white women to be adequately screened for breast cancer, a new study shows, and that disparity could account for why blacks are more likely to be diagnosed with advanced-stage tumors and die from the disease.
The study, led by a University of California, San Francisco radiologist, looked at more than 1 million women over age 40 who had received mammograms between 1996 and 2000. The data show blacks, Hispanics, Asians and American Indians are less likely than white women to get mammograms every one to two years, as recommended.
It is the first research to directly link the pattern of how regularly a woman gets a mammogram with the stage of her tumors at the time she's diagnosed. Researchers hope to use the study to generate more targeted screening for minorities.
"I think we've been a little complacent because we thought disparity was no longer a persistent issue," said lead author Rebecca Smith-Bindman, associate professor of radiology at UCSF.
Numbers
Of the million-plus women screened, 17,558 were diagnosed with breast cancer. The researchers evaluated whether overall and advanced cancer rates were similar across racial and ethnic groups, and whether these rates were affected by the use of mammography.
"It turns out all racial minorities were inadequately screened," Smith-Bindman said.
Compared with 72 percent of white women, only 63 to 68 percent of black, Hispanic, Asian and American Indian women were frequently screened.
Black, Hispanic and Asian women were more likely to have their first mammogram because of a physical examination finding or breast cancer symptom.
Of those with cancer, 18 percent of white women versus 35 percent of black women had not received recommended breast cancer screening every one to two years. Hispanic women also had longer intervals between mammograms and, like blacks, were more likely to have advanced-stage tumors at diagnosis and to die of breast cancer than white women.
Although Asian and American Indian women had fewer mammograms than white women, they also had significantly lower rates of cancer and had lower rates of large, advanced-stage tumors. If these two groups of women were screened regularly, Smith-Bindman said, their outcomes could improve even more.
Contradiction
The findings, published this week in the journal Annals of Internal Medicine, contradicts widely used government health surveys that show only small differences in mammography use between white and nonwhite women.
Those surveys are based on self-reported information, while this latest study relied on records from seven mammography registries -- San Francisco, Seattle, Colorado, Vermont, New Hampshire, North Carolina and New Mexico.