Access and late-stage diagnosis of breast cancer in the military health system.
The results reported in this paper are from a larger study examining the relationship between access and stage at diagnosis of breast cancer in African-American and white women. This paper focuses on the results describing the extent to which potential and realized access predict stage at diagnosis within an equal economic access health care system. Data in this descriptive-comparative study were collected through secondary analysis using the tumor registry records of 62 African-American and 573 white women diagnosed with breast cancer in the military health system between January 1, 1988, and December 31, 1997. Logistic regression analysis revealed that late-stage breast cancer was more likely to be diagnosed in African-American women from low socioeconomic strata with incidental breast self-examination-discovered cancers. The most significant predictors of late-stage diagnosis were means of discovery and the length of time between discovery and diagnosis.
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University of San Diego, Naval Medical Center San Diego, CA 92134, USA.
D000328:Adult; D001741:Black or African American / Q000193:education / Q000523:psychology / Q000706:statistics & numerical data*; D000368:Aged; D001943:Breast Neoplasms / Q000208:ethnology / Q000473:pathology*; D002140:California / Q000453:epidemiology; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006297:Health Services Accessibility / Q000191:economics* / Q000592:standards*; D006801:Humans; D016015:Logistic Models; D008875:Middle Aged; D008887:Military Medicine / Q000191:economics* / Q000592:standards*; D009367:Neoplasm Staging / Q000145:classification*; D011203:Poverty / Q000706:statistics & numerical data*; D011237:Predictive Value of Tests; D012042:Registries; D013997:Time Factors; D044465:White People / Q000193:education / Q000523:psychology / Q000706:statistics & numerical data*