Racism and Low Mammography Rates
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More African American women die of breast cancer. A recent Yale study found, however, that there was no association was observed between perceived racial discrimination and nonadherence to age-specific mammography screening guidelines.
D. Garth Sullivan, from Indox Consulting, expands in a recent mass email:
Perceived racial discrimination is not associated with nonadherence to screening mammography guidelines among African American women, according to findings published in the June issue of the American Journal of Epidemiology.
"The mortality rate from breast cancer continues to be significantly higher for African American women than for white women," lead author Dr. Amy B. Dailey explained in an interview with Reuters Health. "Thoroughly investigating factors that may contribute to this persistent racial disparity is crucial in order to find ways to reduce this gap."
To this end, Dr. Dailey, of Yale University School of Medicine, New Haven, Connecticut, and colleagues prospectively studied 1229 women between the ages of 40 and 79 years who underwent an index screening mammography between October 1996 and January 1998 and completed baseline interviews and follow- up interviews an average of 29 months later. Sixty-one percent of the women were white and 39% were African American.
The researchers assessed perceived discrimination using questions regarding lifetime experiences in seven possible situations. These included attending school, looking for employment, obtaining medical care, at work, at home, situations in a public setting, and treatment by the police or the courts.
Nonadherence to screening recommendations was defined as failing to obtain at least one mammogram within 2 years of the index examination for subjects aged 40 to 49 years and failing to obtain at least two screenings within 2 years of the index examination for subjects aged 50 years or older.
Lifetime racial discrimination was reported by approximately 42% of African-American women and 10% of white women. The most frequently racial discrimination episodes were at work, by the police or in the courts.
Overall, 47.8% of the total study population was nonadherent to screening mammography guidelines. African American women were more likely to be nonadherent than white women (odds ratio = 1.48). However, in multivariate analysis no association was observed between perceived racial discrimination and nonadherence to age-specific mammography screening guidelines.