Lower adherence to screening mammography guidelines among ethnic minority women in America: a meta-analytic review.
OBJECTIVE
This study investigates the association between ethnic minority status and receiving a screening mammogram within the past 2 years among American women over 50.


METHODS
The findings from 33 studies identified from interdisciplinary research databases (1980 to 2006) were synthesized. Separate pooled analyses compared white non-Hispanics to African Americans (28 outcomes), Hispanics (18 outcomes), and Asian/Pacific Islanders (10 outcomes).


RESULTS
Using the random effects model, results showed that African Americans were screened less than white non-Hispanics at a marginal level (OR 0.87, 95% CI 0.75, 1.00). Larger and significant discrepancies were observed for Hispanics (OR 0.65, 95% CI 0.50, 0.85) and Asian/Pacific Islanders (OR 0.63, 95% CI 0.39, 0.99) compared to white non-Hispanics. However, among studies controlling for socioeconomic status, ethnic differences in mammography screening were no longer significant for African Americans (OR 1.05, 95% CI 0.71, 1.76), Hispanics (OR 1.08, 95% CI 0.64, 1.93), or Asian/Pacific Islanders (OR 1.08, 95% CI 0.64, 1.93). Subgroup analyses further showed that geographical region, sampling method, and data collection strategy significantly impacted results.


CONCLUSIONS
This study found evidence that ethnic minority-screening mammography differences exist but were impacted by socioeconomic status. Implications for interpreting existing knowledge and future research needs are discussed.
Purc-Stephenson
Rebecca J
RJ
Department of Psychology, University of Windsor, 401 Sunset Ave., Windsor, Ontario, Canada N9B 3X2. purcste@uwindsor.ca
Gorey
Kevin M
KM
D000368:Aged; D001943:Breast Neoplasms / Q000175:diagnosis* / Q000517:prevention & control; D016001:Confidence Intervals; D005006:Ethnicity; D005260:Female; D006801:Humans; D008327:Mammography / Q000706:statistics & numerical data*; D008403:Mass Screening; D008875:Middle Aged; D008913:Minority Groups; D016017:Odds Ratio; D009864:Ontario; D010342:Patient Acceptance of Health Care; D010349:Patient Compliance; D017410:Practice Guidelines as Topic; D012959:Socioeconomic Factors