title: Breast cancer screening use by African Americans and Whites in an HMO.
abstract: OBJECTIVE
  To examine racial differences in breast cancer screening in an HMO that provides screening at no cost.
  
  
  METHODS
  Retrospective cohort study of breast cancer screening among African-American and white women. Breast cancer screening information was extracted from computerized medical records.
  
  
  METHODS
  A large HMO in New England.
  
  
  METHODS
  White and African-American women (N = 2,072) enrolled for at least 10 years in the HMO.
  
  
  RESULTS
  Primary care clinicians documented recommending a screening mammogram significantly more often for African Americans than whites (70% vs 64%; P <.001). During the 10-year period, on average, white women obtained more mammograms (4.49 vs 3.93; P <.0001) and clinical breast examinations (5.35 vs 4.92; P <.01) than African-American women. However, a woman's race was no longer a statistically significant predictor of breast cancer screening after adjustment for differences in age, estimated household income, estrogen use, and body mass index (adjusted number of mammograms, 4.47 vs 4.25, P =.17; and adjusted number of clinical breast examinations, 5.35 vs 5. 31, P =.87).
  
  
  CONCLUSIONS
  In this HMO, African-American and white women obtained breast cancer screening at similar rates. Comparisons with national data showed much higher screening rates in this HMO for both white and African-American women.
authors.affiliation: Departments of Medicine, University of Washington School of Medicine, Seattle, Washington, USA.
authors.forename: L M
authors.initials: LM
authors.lastname: Reisch
authors.forename: M B
authors.initials: MB
authors.lastname: Barton
authors.forename: S W
authors.initials: SW
authors.lastname: Fletcher
authors.forename: W
authors.initials: W
authors.lastname: Kreuter
authors.forename: J G
authors.initials: JG
authors.lastname: Elmore
mesh_terms: D000328:Adult; D001741:Black or African American; D001900:Boston; D001943:Breast Neoplasms / Q000517:prevention & control*; D005260:Female; D006279:Health Maintenance Organizations; D006801:Humans; D008327:Mammography / Q000706:statistics & numerical data*; D008875:Middle Aged; D012189:Retrospective Studies; D044465:White People