title: Medical barriers to mammography screening of African American women in a high cancer mortality area: implications for cancer educators and health providers.
abstract: African American women have a higher breast cancer mortality rate than whites even when cancer subtype is considered, are more likely to be diagnosed at a later stage, and are less likely to have mammography screening. Structural barriers limit screening but may be less important than clinical care and personal barriers among minority and lower income women. A random sample of 178 African American females aged >40 years from a high cancer risk area was surveyed to associate mammography screening with clinical, structural, and personal barriers. Clinical barriers including patient education and communication were significantly associated with lack of screening in previous 2 years. Personal barriers (lack of trust and knowledge) and structural barriers (lack of insurance, facilities, and providers) also reduced screening. Results reveal that medical practitioners should be more pro-active in reducing clinical barriers to mammography screening among lower income African American women. Improved patient physician communication, education about breast cancer to build knowledge and reduce fears, referral for mammography, and building trust are indicated.
authors.affiliation: Department of Family Medicine and Public Health Sciences, Wayne State University School of Medicine, 3939 Woodward, Detroit, 48201 MI, USA. ryoung@med.wayne.edu
authors.forename: Rosalie F
authors.initials: RF
authors.lastname: Young
authors.forename: Kendra
authors.initials: K
authors.lastname: Schwartz
authors.forename: Jason
authors.initials: J
authors.lastname: Booza
mesh_terms: D001741:Black or African American / Q000523:psychology*; D001294:Attitude to Health; D001943:Breast Neoplasms / Q000000981:diagnostic imaging* / Q000208:ethnology; D003430:Cross-Sectional Studies; D005260:Female; D015438:Health Behavior / Q000208:ethnology*; D019538:Health Care Surveys; D006266:Health Education; D007722:Health Knowledge, Attitudes, Practice; D006297:Health Services Accessibility; D006801:Humans; D008327:Mammography / Q000706:statistics & numerical data*; D008403:Mass Screening; D008875:Middle Aged; D010820:Physicians / Q000523:psychology*; D012307:Risk Factors; D044465:White People / Q000523:psychology