title: Mammography screening trends: the perspective of African American women born pre/post World War II.
abstract: Researchers have traditionally combined aging women (aged > or =50 years) when reporting their mammography use. This may inadvertently mask important cohort effects in mammography use, which are likely to result from distinct personal life experiences and generational differences. Using the Health and Retirement Study samples of 1998, 2000, and 2004, we examined cohort differences in mammography use between African American women born before 1946 (non-baby boomers) and those born in 1946 to 1953 (baby boomers). Between 1998 and 2004, screening rates for non-baby boomers declined, while those for baby boomers remained relatively steady. Hierarchical linear modeling (HLM) analyses suggest that while screening rates decreased with age (OR, 0.957; 95% CI, 0.947-0.968) cohort effects may have partially reversed the age effect, with non-baby boomers having an increased likelihood of receiving a mammogram compared to baby boomers (OR, 1.697; 95% CI, 1.278-2.254). Because African American women are diagnosed at later stages of breast cancer, documentation of cohort differences in mammography use among older African American women is important as health care professionals design intervention programs that are maximally effective for women from different cohorts. This is particularly critical as more African American women in the baby boomer cohort become part of the aging population.
authors.affiliation: Department of Obstetrics, Gynecology, and Reproductive Biology, College of Human Medicine, Michigan State University, East Lansing, Michigan 48824-1316, USA. karen.williams@ht.msu.edu
authors.forename: Karen Patricia
authors.initials: KP
authors.lastname: Williams
authors.forename: Athur
authors.initials: A
authors.lastname: Mabiso
authors.forename: Yun-Jia
authors.initials: YJ
authors.lastname: Lo
authors.forename: Louis A
authors.initials: LA
authors.lastname: Penner
mesh_terms: D001741:Black or African American; D017677:Age Distribution; D000367:Age Factors; D000368:Aged; D001943:Breast Neoplasms / Q000000981:diagnostic imaging* / Q000208:ethnology; D042241:Early Diagnosis; D005260:Female; D006801:Humans; D008327:Mammography / Q000639:trends*; D008403:Mass Screening / Q000379:methods* / Q000639:trends; D008824:Michigan / Q000453:epidemiology; D008875:Middle Aged; D015203:Reproducibility of Results; D012189:Retrospective Studies; D013997:Time Factors; D016387:Women's Health; D047789:World War II