title: Performance of digital screening mammography in a population-based cohort of black and white women.
abstract: OBJECTIVE
  There is scarce information on whether digital screening mammography performance differs between black and white women.
  
  
  METHODS
  We examined 256,470 digital screening mammograms performed from 2005 to 2010 among 31,654 black and 133,152 white Carolina Mammography Registry participants aged ≥40 years. We compared recall rate, sensitivity, specificity, and positive predictive value (PPV1) between black and white women, adjusting for potential confounders using random effects logistic regression.
  
  
  RESULTS
  Breast cancer was diagnosed in 276 black and 1,095 white women. Recall rates were similar for blacks and whites (8.6 vs. 8.5 %), as were sensitivity (83.7 vs. 82.4 %), specificity (91.8 vs. 91.9 %), and PPV1 (4.8 vs. 5.3 %) (all p values >0.05). Stratified and adjusted models showed similar results. Despite comparable mammography performance, tumors diagnosed in black women were more commonly poorly differentiated and hormone receptor negative.
  
  
  CONCLUSIONS
  Equivalent performance of digital screening mammography by race suggests that efforts to understand tumor disparities should focus on etiologic factors that influence tumor biology.
authors.affiliation: Department of Radiology, The University of North Carolina, Chapel Hill, NC, USA. Louise_Henderson@med.unc.edu.|Department of Epidemiology, The University of North Carolina, Chapel Hill, NC, USA. Louise_Henderson@med.unc.edu.
authors.forename: Louise M
authors.initials: LM
authors.lastname: Henderson
authors.affiliation: Department of Radiology, The University of North Carolina, Chapel Hill, NC, USA.
authors.forename: Thad
authors.initials: T
authors.lastname: Benefield
authors.affiliation: Department of Radiology, The University of North Carolina, Chapel Hill, NC, USA.
authors.forename: Sarah J
authors.initials: SJ
authors.lastname: Nyante
authors.affiliation: Department of Radiology, The University of North Carolina, Chapel Hill, NC, USA.
authors.forename: Mary W
authors.initials: MW
authors.lastname: Marsh
authors.affiliation: Department of Radiology, The University of North Carolina, Chapel Hill, NC, USA.
authors.forename: Mikael Anne
authors.initials: MA
authors.lastname: Greenwood-Hickman
authors.affiliation: Department of Radiology, The University of North Carolina, Chapel Hill, NC, USA.|Carolina Breast Imaging Specialists, Greenville, NC, USA.|Departments of Radiology and Oncology, The Brody School of Medicine at East Carolina University, Greenville, NC, USA.
authors.forename: Bruce F
authors.initials: BF
authors.lastname: Schroeder
mesh_terms: D000328:Adult; D001741:Black or African American; D000368:Aged; D000369:Aged, 80 and over; D001943:Breast Neoplasms / Q000000981:diagnostic imaging* / Q000208:ethnology* / Q000473:pathology; D055088:Early Detection of Cancer; D005260:Female; D006801:Humans; D016015:Logistic Models; D008327:Mammography; D008875:Middle Aged; D011237:Predictive Value of Tests; D012042:Registries; D012680:Sensitivity and Specificity; D044465:White People
keywords: Breast cancer; Disparities; Positive predictive value; Screening mammography; Sensitivity; Specificity