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Elderly, low-income black women need more education about the importance of breast cancer screening

Elderly women account for more than 50 percent of breast cancer deaths, and black women—who are more likely than white women to be diagnosed when their cancer is at a later stage—die more often from the disease. Unfortunately, among low-income black women, the oldest women know the least about breast cancer and are least likely to obtain mammogram screening. One reason that elderly black women are underscreened might be their under assessment of their personal cancer risk, suggests Alma R. Jones, M.D., M.P.H., of Morehouse School of Medicine.

In a recent study, Dr. Jones and her colleagues found that over three-fourths of low-income black women in each of three age groups (65-74, 75-84, and 85 and older) underestimated their own risk of getting breast cancer. Moreover, with increasing age, the percentage of women who believed they had no chance of getting breast cancer tripled from 20 percent in those 65-74 years to nearly 60 percent in those 85 years and older. These age-related trends in knowledge, beliefs, and practices strongly suggest that elderly black women, particularly those older than 84, need to be better educated about breast cancer, with an emphasis on screening, conclude the researchers.

Their findings are based on data collected at senior citizen facilities from 214 elderly black women. They assessed differences in breast cancer knowledge, beliefs, and screening practices across the three age groups and calculated the effect of these factors on compliance with American Cancer Society (ACS) screening guidelines. Age was inversely associated with knowledge and screening practices. The youngest group (65-74 years) was about twice as likely as the oldest group (85 years and over) to correctly recognize breast cancer risk factors. Women in the oldest group were also least likely to have had a mammogram or clinical breast examination within the past year, as recommended by the ACS. This research was supported in part by the Agency for Healthcare Research and Quality (HS10875).

Details are in "Breast cancer knowledge, beliefs, and screening behaviors among low-income elderly black women," by Dr. Jones, Corleen J. Thompson, M.S.P.H., Ph.D., Robert A. Oster, Ph.D., and others, in the September 2003 Journal of the National Medical Association 95(9), pp. 791-805.

Editor's Note: Another study on a related topic shows that a higher level of perceived emotional support is significantly associated with increased breast cancer survival in black and white women. For more details, see Soler-Vila, H., Kasi, S.V., and Jones, B.A. (2003, September). "Prognostic significance of psychosocial factors in African-American and white breast cancer patients." (AHRQ grant HS06910). Cancer 98, pp. 1299-1308.

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