A prospective assessment of racial/ethnic differences in future mammography behavior among women who had early mammography.
BACKGROUND
Twenty-nine percent of women, aged 30 to 39, report having had a mammogram, though sensitivity and specificity are low. We investigate racial/ethnic differences in future mammography behavior among women who had a baseline screening mammogram prior to age 40.


METHODS
Using 1994-2008 data from the Breast Cancer Surveillance Consortium (BCSC), we identified 29,390 women aged 35 to 39 with a baseline screening mammogram. We followed this cohort for 2 outcomes: (i) future BCSC mammography between ages 40 and 45; and (2) among those, delay in screening mammography until ages 43 to 45 compared with ages 40 to 42. Using adjusted log-linear models, we estimated the relative risk (RR) of these outcomes by race/ethnicity, while also considering the impact of false-positive/true-negative (FP/TN) baseline mammography results on these outcomes.


RESULTS
Relative to non-Hispanic white women, Hispanic women had an increased risk of no future BCSC mammography (RR: 1.21, 95% CI: 1.13-1.30); Asian women had a decreased risk (RR: 0.67, 95% CI: 0.61-0.74). Women with a FP result, compared with a TN result, had a decreased risk of no future BCSC mammography (RR: 0.89, 95% CI: 0.85-0.95). Among those with future BCSC screening mammography, African American women were more likely to delay the timing (RR: 1.26, 95% CI: 1.09-1.45). The interaction between race/ethnicity and FP/TN baseline results was not significant.


CONCLUSIONS
Race/ethnicity is differentially associated with future BCSC mammography and the timing of screening mammography after age 40.


CONCLUSIONS
These findings introduce the need for research that examines disparities in lifetime mammography use patterns from the initiation of mammography screening.
Department of Family and Community Medicine, University of Missouri, MA306 Medical Sciences Bldg, 1 Hospital Drive, Columbia, MO 65212, USA. kappj@health.missouri.edu
Julie M
JM
Kapp
Rod
R
Walker
Sebastien
S
Haneuse
Bonnie C
BC
Yankaskas
D000328:Adult; D000367:Age Factors; D001943:Breast Neoplasms / Q000000981:diagnostic imaging* / Q000208:ethnology* / Q000523:psychology; D015331:Cohort Studies; D005006:Ethnicity; D005260:Female; D006801:Humans; D008327:Mammography / Q000523:psychology / Q000706:statistics & numerical data*; D008875:Middle Aged; D011446:Prospective Studies
Ann Intern Med. 2009 Nov 17;151(10):716-26, W-236
19920272
Ann Intern Med. 1999 Jul 6;131(1):1-6
10391809
CA Cancer J Clin. 2010 Mar-Apr;60(2):99-119
20228384
Ann Intern Med. 2006 Apr 18;144(8):541-53
16618951
Ann Intern Med. 1991 Apr 15;114(8):657-61
2003712
J Natl Cancer Inst. 2010 May 19;102(10):692-701
20439838
Am Fam Physician. 1997 Feb 1;55(2):567-76, 581-2
9054225
Ann Intern Med. 2002 Sep 3;137(5 Part 1):344-6
12204019
Radiology. 1998 Jul;208(1):245-9
9646820
J Community Health. 2008 Aug;33(4):183-91
18369711
Am J Prev Med. 2010 Jun;38(6):610-9
20494237
Cancer. 1992 Apr 1;69(7 Suppl):1885-7
1544086
Breast Cancer Res Treat. 2010 Nov;124(1):213-22
20204501
AJR Am J Roentgenol. 1997 Oct;169(4):1001-8
9308451
Ann Intern Med. 2007 Apr 3;146(7):502-10
17404352
J Womens Health (Larchmt). 2008 Nov;17(9):1477-98
18954237
J Gen Intern Med. 2008 Sep;23(9):1354-60
18506542
Health Serv Res. 2001 Dec;36(6 Pt 2):78-89
16148962
Cancer. 1992 Apr 1;69(7 Suppl):1913-8
1544091
N Engl J Med. 2003 Apr 24;348(17):1672-80
12711743
Cancer Epidemiol. 2009 Jul;33(1):72-8
19481879
Radiology. 2008 Dec;249(3):785-91
18941163
Breast Cancer Res Treat. 2009 Jan;113(2):327-37
18264758