Breast cancer disparities: Examining concordance rates among self-reported mammography and medical records in an urban community

Background: Survey data used to estimate breast cancer screening prevalence are often over-reported. The extent of this over-reporting is unclear as is whether women of different races and ethnicities similarly over-report. To determine whether there is variation in mammography prevalence by racial/ethnic group, we explore the accuracy of self-reported screening rates compared to mammography history from medical records. Methods: Venue-based community sampling was employed to conduct a health survey with 2,200 Black, Puerto Rican and Mexican women age 40 and over residing in two very poor communities on Chicago's Westside. Survey data were gathered from March to June 2008 and 70% of respondents provided HIPAA authorization to review their medical records. Mammography history in the last 5 years was meticulously double-abstracted from imaging and pathology reports from 18 different medical centers for n= 1,272 women. Results: The Healthy People 2010 goal for receipt of a mammogram in the past 2 years is 70%. In our survey 64% of Black women, 65% of Mexican women, and 70% of Puerto Rican women reported a mammogram in the past 2 years. However, comprehensive chart reviews suggested that actual prevalence of mammography use was substantially lower. Sensitivity, specificity and predictive values were also calculated and will be presented. Conclusion: There was significant over-reporting of mammography utilization in three race/ethnicity groups. In our sample of women, self-reported mammography use substantially over-estimated actual use, and our results suggest that we are much further from reaching the target of 70% of women with a recent mammogram.