title: Racial Disparities in Screening Mammography in the United States: A Systematic Review and Meta-analysis.
abstract: OBJECTIVE
  Many studies have suggested that disparities exist in the use of medical screening tests. The purpose of this study was to assess racial disparities in screening mammography in the United States via a systematic review and meta-analysis.
  
  
  METHODS
  We searched MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials, Cochrane Database of Systematic Reviews, and Scopus for comparative studies published between 1946 and 2015 comparing utilization of mammography among various racial groups. Two independent reviewers extracted data and appraised study. Meta-analysis was conducted when appropriate using the random-effects model.
  
  
  RESULTS
  A total of 5,818,380 patients were included across 39 relevant studies; 43.1% of patients were white, 33.3% were black, 17.4% were Hispanic, and 6.2% were Asian/Pacific Islander. Black and Hispanic populations had lower odds of utilizing screening mammography when compared with the white population (odds ratio [OR] = 0.81; 95% confidence interval [CI], 0.72-0.91; I2= 89.4% and OR = 0.83; 95% CI, 0.74-0.93, respectively). For African Americans, these disparities were present in both the 40 to 65 age group and the >65 age group; for Hispanics, these differences were present only in the 40 to 65 age group. There was no difference in mammography utilization between Asians/Pacific Islanders and whites (OR = 1.82; 95% CI, 0.09-38.41).
  
  
  CONCLUSIONS
  Racial disparities in utilization of screening mammography are evident in black and Hispanic populations in the United States. Further studies are needed to understand reasons for disparities, trends over time, and the effectiveness of interventions targeting these disparities.
authors.affiliation: Evidence-based Practice Center, Mayo Clinic Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery, Division of Preventive, Occupational and Aerospace Medicine, Mayo Clinic, Rochester, Minnesota. Electronic address: Ahmed.Ahmed1@mayo.edu.
authors.forename: Ahmed T
authors.initials: AT
authors.lastname: Ahmed
authors.affiliation: Department of Radiology, Mayo Clinic, Rochester, Minnesota.
authors.forename: Brian T
authors.initials: BT
authors.lastname: Welch
authors.affiliation: Department of Radiology, Mayo Clinic, Rochester, Minnesota.
authors.forename: Waleed
authors.initials: W
authors.lastname: Brinjikji
authors.affiliation: Evidence-based Practice Center, Mayo Clinic Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery, Division of Preventive, Occupational and Aerospace Medicine, Mayo Clinic, Rochester, Minnesota.
authors.forename: Wigdan H
authors.initials: WH
authors.lastname: Farah
authors.affiliation: Department of Radiology, Mayo Clinic, Rochester, Minnesota.
authors.forename: Tara L
authors.initials: TL
authors.lastname: Henrichsen
authors.affiliation: Evidence-based Practice Center, Mayo Clinic Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery, Division of Preventive, Occupational and Aerospace Medicine, Mayo Clinic, Rochester, Minnesota.
authors.forename: M Hassan
authors.initials: MH
authors.lastname: Murad
authors.affiliation: Department of Radiology, Mayo Clinic, Rochester, Minnesota.
authors.forename: John M
authors.initials: JM
authors.lastname: Knudsen
mesh_terms: D001741:Black or African American / Q000706:statistics & numerical data; D001943:Breast Neoplasms / Q000000981:diagnostic imaging / Q000208:ethnology*; D055088:Early Detection of Cancer / Q000706:statistics & numerical data*; D005260:Female; D015276:Health Care Rationing / Q000706:statistics & numerical data; D006297:Health Services Accessibility / Q000706:statistics & numerical data*; D054625:Healthcare Disparities / Q000208:ethnology* / Q000706:statistics & numerical data*; D006630:Hispanic or Latino / Q000706:statistics & numerical data; D006801:Humans; D008327:Mammography / Q000706:statistics & numerical data*; D044469:Racial Groups / Q000706:statistics & numerical data; D063505:Racism / Q000208:ethnology / Q000706:statistics & numerical data*; D014481:United States / Q000453:epidemiology; D044465:White People / Q000706:statistics & numerical data
keywords: Mammography; disparities; meta-analysis; racial; systematic review