Online Program

Examining racial and nativity disparities in mammography by breast cancer risk

Tuesday, November 3, 2015

Bilikisu Elewonibi, M.P.H., Department of Health Policy and Adminstration, The Pennsylvania State University, Univeristy Park, PA
Katsuya Oi, M.A., Department of Sociology, The Pennsylvania State University, University Park, PA
Amy Thierry, M.P.H., Department of Biobehavioral Health, The Pennsylvania State University, University Park, PA
Patricia Y. Miranda, MPH, PhD, Department of Health Policy and Administration, The Pennsylvania State University, University Park, PA
Background: Ethnic minority and foreign-born women consistently report lower rates of mammography screening compared to non-Hispanic white, U.S.-born women even though they have increased risk for developing breast cancer and increased mortality due to this disease.

Objective: This study examines disparities in mammography across breast cancer risk groups and determines whether such disparities are explained by socioeconomic factors. 

Methods: Propensity score methodology was used to classify individuals from the 2000, 2005, and 2010 National Health Interview Survey according to their risk for developing breast cancer and logistic regression models were used to predict the likelihood of mammography. 

Results: Compared to non-Hispanic white women, Mexican women (OR: 0.684, p<0.001), Asian women (OR: .785 p <.001) and women of “other” racial/ethnic origin (OR: .785, p<.001) were less likely to have had a mammogram. Being foreign-born  decreased the odds of receiving a mammogram by nearly 10% (OR: 0.904, p<0.05). Once controlling for breast cancer risk, socioeconomic status and health care resources, Mexican (OR: 1.228, p<0.001), Cuban (OR: 1.530, p<0.01), Dominican (OR: 2.037, p<0.001), Central American (OR: 1.623, p<0.001), Black (OR: 1.405, p<0.001), and foreign-born (OR: 1.108, p<0.05) women had an increased likelihood of receiving a mammogram.  Conversely, Asian (ORs: 0.79, p<0.001) women remained less likely to have had a mammogram.

Conclusions: Breast cancer risk should be considered along with socioeconomic factors and other cultural barriers in order to understand and address mammography disparities. Policies are needed to assist high-risk, low-resource women in obtaining recommended mammograms.


Learning Areas:

Planning of health education strategies, interventions, and programs
Provision of health care to the public
Social and behavioral sciences

Learning Objectives:
Discuss possible explanations for mammography disparities Compare trends in mammography use Assess the role of breast cancer risk in obtaining a mammogram

Keyword(s): Cancer Prevention and Screening, Health Disparities/Inequities

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I have been the principal or co-principal author of multiple papers focusing on health disparities in US populations. Among my interests has been strategies to reduce breast cancer mortality and screening disparities in minority populations.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.