title: Understanding the role of reactions to race-based treatment in breast and cervical cancer screening.
abstract: Racial and ethnic disparities in breast and cervical cancer mortality persist despite effective screening methods. We examined associations between race/ethnicity and Pap testing within three years or mammography within two years, controlling for a composite reactions-to-race-based-treatment variable created using data from the 2002 and 2004 Behavioral Risk Factor Surveillance System Reactions to Race module, which assessed respondents experiences based on one's race. We calculated prevalence of Pap testing (for women aged > or = 18) and mammography (for women aged > or = 40) by race, and fit logistic regression models to estimate the strength of association of reactions to race-based treatment with screening and race--before and after controlling for demographics, socioeconomic status, health status, smoking and healthcare access. In the reduced model, black women were more likely (2.03: 95% CI: 1.55-2.65) to be screened for cervical cancer than whites. Reactions to race-based treatment did not impact the odds of black women receiving Pap tests or mammograms. Given current racial and ethnic disparities in breast and cervical cancer mortality, we suggest that more attention needs to be focused on follow-up of abnormal results and state-of-the art treatment for black and Hispanic women.
authors.affiliation: Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY 10032, USA. ndcrawford@gmail.com
authors.forename: Natalie D
authors.initials: ND
authors.lastname: Crawford
authors.forename: Camara P
authors.initials: CP
authors.lastname: Jones
authors.forename: Lisa C
authors.initials: LC
authors.lastname: Richardson
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001294:Attitude to Health; D001943:Breast Neoplasms / Q000175:diagnosis* / Q000208:ethnology / Q000517:prevention & control; D005006:Ethnicity; D005260:Female; D015438:Health Behavior; D019538:Health Care Surveys; D006304:Health Status; D054624:Health Status Disparities; D006801:Humans; D008327:Mammography / Q000706:statistics & numerical data; D008403:Mass Screening; D008875:Middle Aged; D015995:Prevalence; D044469:Racial Groups; D012959:Socioeconomic Factors; D002583:Uterine Cervical Neoplasms / Q000175:diagnosis* / Q000208:ethnology / Q000517:prevention & control; D014626:Vaginal Smears