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Mythreyi Bhargavan, PhD, Jonathan Sunshine, PhD, and Cristian Meghea, PhD. Research, American College of Radiology, 1891 Preston White Drive, Reston, VA 20191, 703-648-8983, cmeghea@acr.org

Objective: Early detection by mammography screening had a sizeable contribution to the reduction in breast cancer mortality over the recent years, but there are persistent variations in mortality rates by race and ethnicity. The objective of this paper is to measure racial and ethnic disparities in mammography screening in 2003 and trends over time since 1996

Data and Methods We use data from the Medical Expenditure Panel Surveys (MEPS) for 1996-2003. MEPS surveys are nationally representative and have detailed information on individual race/ethnicity and socio-economic characteristics. Two measures are used: the percent of women age 40 and older who had a mammogram in 2003, from MEPS's medical records; and the percent of MEPS female respondents, age 40 or older, who said they had a mammogram in the past two years. We also use multivariate regression analysis to isolate the individual effects of race and other characteristics on variations in mammography screening.

Results MEPS medical records show that 28% of all white women age 40 or older in US had a screening mammogram in 1998, while only 18% of black women had one. The percentages for Hispanic women and Asian women were 15% and 21%. The disparities persisted in 2003: 30% of white women age 40 or older had a mammogram, while only 19% of black women, 17% of Hispanic women, and 16% of Asian women had one. When asked if they had a mammogram in the past two years, 70% of white women answered “yes” in 1998, and 69% of black women answered the same. The percentages for Hispanic women and Asian women were 61% and 48%. The numbers in 2003 were 72% for white women, 72% for black women, 62% for Hispanic women, and 56% for Asian women. Regression results show that racial and ethnic disparities remain even after controlling for other factors.

Conclusions: Estimates of disparities in mammography screening between white and black women depend on how the question is asked. Our finding persists over time, and is present in two different datasets. However, there are clear disparities in mammography screening between white and Hispanic and Asian women.

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