The relationship between access and stage at diagnosis of breast cancer in African American and Caucasian women.
OBJECTIVE
To identify the relationships among potential access, realized access, and stage at diagnosis of breast cancer in African American and Caucasian women receiving care within an equal economic access healthcare system.


METHODS
Descriptive-comparative design.


METHODS
Department of Defense Military Health System.


METHODS
62 African American and 573 Caucasian women (ages 25-97) diagnosed with breast cancer over a 10-year period.


METHODS
Secondary analysis using tumor registry records data.


METHODS
Economic, potential, and realized access and stage at diagnosis of breast cancer.


RESULTS
When compared to Caucasian women, African American women were diagnosed at later stages, were younger when diagnosed, were from a lower socioeconomic status, had a higher percentage of incidental breast self-examination-discovered abnormalities, and had a lower percentage of mammogram-discovered abnormalities.


CONCLUSIONS
Economic access to care did not always result in early diagnosis. Other factors such as age, race, socioeconomic status, and means of discovery influenced diagnosis outcomes.


CONCLUSIONS
Interventions aimed at increasing participation in breast health programs also should focus on noneconomic aspects of access such as help-seeking behaviors and perceptions of access to care. Additional studies should be conducted to evaluate adherence to breast cancer screening guidelines by women receiving care within equal economic access healthcare systems.
Bibb
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SC
United States Navy, Camp Pendleton, CA, USA. sbibb@aol.com
D000328:Adult; D001741:Black or African American / Q000706:statistics & numerical data*; D000368:Aged; D000369:Aged, 80 and over; D001943:Breast Neoplasms / Q000175:diagnosis* / Q000451:nursing / Q000473:pathology; D002140:California; D005260:Female; D006297:Health Services Accessibility; D006801:Humans; D008875:Middle Aged; D008889:Military Personnel; D009367:Neoplasm Staging; D010342:Patient Acceptance of Health Care / Q000208:ethnology; D012959:Socioeconomic Factors; D013997:Time Factors; D044465:White People / Q000706:statistics & numerical data*