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Disparities/Minority Health

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Black women who live in rural areas are less likely than white women to begin mammography screening

Regular mammography screening for breast cancer is recommended at least once every 2 years for women between 50 and 74 years of age. Once women begin mammography screening, they are likely to continue being screened. However, black women who live in rural areas are less likely than white women to get an initial mammogram, according to a study supported in part by the Agency for Healthcare Research and Quality (HS00007).

Researchers examined mammography screening over a 7-year period in a group of women aged 52 and older from the North Carolina Breast Cancer Screening Program who lived in rural areas. They compared baseline (1993-1994), first (1996-1997), and second followup (2000) interviews with 336 white and 314 black women. They evaluated baseline factors predictive of regular mammography screening (a mammogram in the past 2 years at all three interviews) and initiation of mammography for women who have not had prior regular mammograms.

Among all women, a mammogram in the past 2 years increased from 67 percent at the baseline interview to 78 percent at the second followup interview. Most of this increase occurred among women who had never had a mammogram, for whom recent screening increased from 27 percent to 58 percent. Among women who had never had a mammogram, white women were twice as likely as black women to begin having regular mammograms (29 versus 17 percent). White and black women were equally likely to receive regular mammograms if they had received one previously (i.e., if they had ever had a mammogram in the past). Younger women (aged 52 to 64) who had never received a mammogram were three times more likely than older women who had never received one to begin regular mammography screening. Physician recommendation was the strongest predictor of both initiation and maintenance of regular mammography screening.

See "Baseline predictors of initiation vs. maintenance of regular mammography use among rural women," by Garth H. Rauscher, Ph.D., M.P.H., Sarah Tropman Hawley, Ph.D., and Jo Anne L. Earp, Sc.D., in the June 2005 Preventive Medicine 40, pp. 822-830.

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