Racial differences in breast cancer screening among women from 65 to 74 years of age: trends from 1987-1993 and barriers to screening.
Breast cancer mortality is decreasing for elderly white women but increasing for elderly black women. National surveys were used to study racial differences in breast cancer screening and effects of Medicare funding for mammography and to examine explanatory fac- tors. A total of 13,545 women, aged 65-74, from the Health Care Finance Administration's Master Beneficiary File participated. After Medicare funding for screening mammography, the percent reporting a mammogram increased for white women, but not for black women. Clinical breast examination and breast self-examination decreased. Physician's recommendation, geographic area, education level and health status were the variables significantly affecting mammography usage for both races. Physicians recommended mammography more often if women were white, married, educated beyond high school and had an annual income greater than $20,000. These results support the need to design and test strategies specifically for black women and interventions to emphasize physician recommendations for breast cancer screening.
Coleman
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University of Arkansas for Medical Sciences, Little Rock 72205, USA. ColemanAnn@uams.edu
O'Sullivan
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P
D001741:Black or African American / Q000706:statistics & numerical data*; D000368:Aged; D001294:Attitude to Health / Q000208:ethnology; D001943:Breast Neoplasms / Q000208:ethnology* / Q000517:prevention & control* / Q000523:psychology; D016504:Breast Self-Examination / Q000523:psychology / Q000706:statistics & numerical data; D016009:Chi-Square Distribution; D003466:Cultural Characteristics; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D016015:Logistic Models; D008327:Mammography / Q000706:statistics & numerical data*; D008403:Mass Screening / Q000379:methods / Q000706:statistics & numerical data*; D010817:Physician-Patient Relations; D014481:United States / Q000453:epidemiology; D014483:United States Dept. of Health and Human Services; D044465:White People / Q000706:statistics & numerical data*