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Inadequate communication of mammogram results may prevent black women from fully benefiting from screening

Black women continue to be diagnosed at later stages of breast cancer than white women. A new study suggests that poorer communication of mammogram results may not allow black women to benefit fully from mammography screening and may underlie their later diagnosis of breast cancer. The researchers compared self-reported mammogram results via telephone interview with results listed in the radiology record of 411 black and 734 white women. The women underwent mammography screening at five hospital-based facilities in Connecticut between 1996 and 1998.

The researchers categorized the results of mammograms as negative, benign, probably benign, suspicious, or highly suggestive of malignancy. Women were asked what they were told about their mammogram results and what they were asked to do next. There was no difference in the proportion of abnormal screening mammograms between the two racial groups, according to the radiology records.

Overall, communication of mammogram results was problematic for 14.5 percent of the women in the study (12.5 percent had not received their screening result, and 2 percent had received their result, but their self-report differed from the radiology record). Inadequate communication of mammogram results was nearly twice as common among black women than white women (21 vs. 11 percent), even after adjustment for other sociodemographic, clinical, and care access factors. Also, abnormal results were more likely to be inadequately communicated to black women (31 percent of abnormal results vs. 19 percent of normal results), but not to white women. Among women in the study who had abnormal results, 44 percent of those in the inadequate communication group (many of whom believed their mammogram was normal) compared with 29 percent of those in the adequate communication group did not receive adequate followup. The study was supported in part by the Agency for Healthcare Research and Quality (HS11603).

See "Adequacy of communicating results from screening mammograms to African American and white women," by Beth A. Jones, Ph.D., M.P.H., Kam Reams, M.P.H., Lisa Calvocoressi, Ph.D., M.S.W., and others, in the March 2007 American Journal of Public Health 97(3), pp. 531-538.

Editor's Note: Another AHRQ-supported study (HS15686) on a related topic found that perceived racial discrimination was not associated with nonadherence to age-specific mammography screening guidelines. For more details, see: Dailey, A.B., Kasl, S.V., Holford, T.R., and Jones, B.A. (2007, June). "Perceived racial discrimination and nonadherence to screening mammography guidelines: Results from the race differences in the screening mammography process study." American Journal of Epidemiology 165(11), pp. 1287-1295.

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