Family history of breast cancer and socio-demographic correlates of cancer screening with African American and Caucasian women: Results from the 2005 California Health Interview Survey

BACKGROUND: Despite similar prevalence rates, breast cancer mortality rates among African American women are significantly higher than among Caucasian women. This disparity has been attributed, in part, to later stage at diagnosis. This study examines family history and socio-demographic correlates of mammography and clinical breast exam (CBE). METHODS: A sub-sample of African American and Caucasian women 40 years and older (n = 15,038) participating in the 2005 California Health Interview Survey were selected. Multivariate logistic regression models were estimated to examine relationships between various socio-demographic and socioeconomic factors and two-year mammography and past-year CBE. RESULTS: Race was not significantly associated with two-year mammography screening rate. In contrast, having health insurance (OR = 2.08 95% CI=1.65, 2.61) and first-degree female relatives with breast cancer histories (OR = 1.89 95% CI=1.41, 2.52) were significantly associated with two-year mammography. Being African American (OR = 1.37 95% CI=1.10, 1.70), married (OR=1.36 95% CI=1.15, 1.61) and having health insurance (OR=2.88 95% CI=2.45, 3.37) were significantly associated with having a past-year CBE. Having first-degree female relatives with breast cancer histories was not significantly associated with past-year CBE. CONCLUSIONS: There may be racial/ethnic variations in breast cancer screening practices, which may be partially attributable to a variety of socio-demographic and socio-economic differences. Strategies to increase early breast cancer detection among African American women should include interventions addressing group-specific determinants of cancer screening practices. Culturally and contextually appropriate interventions that promote not only awareness, but also knowledge and action, should improve breast cancer outcomes among African American women.