 |
 |
|
Home |
Current Issue |
Past Issues |
In the Clinic |
ACP Journal Club |
CME |
Collections |
Audio/Video |
Mobile |
Subscribe |
Tools |
Help |
ACP Online
|
| ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
1 May 1998 | Volume 128 Issue 9 | Pages 729-736
Background: Older black women are less likely to undergo mammography and are more often given a diagnosis of advanced-stage breast cancer than older white women.
Objective: To investigate the extent to which previous mammography explains observed differences in cancer stage at diagnosis between older black and white women with breast cancer.
Design: Retrospective cohort study using the Linked Medicare-Tumor Registry Database.
Setting: Population-based data from three geographic areas of the United States included in the National Cancer Institute's Surveillance, Epidemiology, and End Results (SEER) program (Connecticut; metropolitan Atlanta, Georgia; and Seattle-Puget Sound, Washington).
Participants: Black and white women 67 years of age and older in whom breast cancer was diagnosed between 1987 and 1989.
Measurements: Medicare claims were used to classify women according to mammography use in the 2 years before diagnosis as nonusers (no previous mammography), regular users (
Results: Black women were more likely to not undergo mammography (odds ratio [OR], 3.00 [95% CI, 2.41 to 3.75]) and to be given a diagnosis of late-stage disease (OR, 2.49 [CI, 1.59 to 3.92]) than white women. When women were stratified by previous mammography use, the black-white difference in cancer stage occurred only among nonusers (adjusted OR, 2.54 [CI, 1.37 to 4.71]). Among regular users, cancer was diagnosed in black and white women at similar stages (adjusted OR, 1.34 [CI, 0.40 to 4.51]). In logistic modeling, previous mammography alone explained about 30% of the excess late-stage disease in black women. In a separate model, previous mammography explained 12% of the excess late-stage disease among black women after adjustment for sociodemographic and comorbidity information.
Conclusion: Differences in breast cancer stage at diagnosis between older black and white women are related to previous mammography use. Increased regular use of mammography may result in a shift toward earlier-stage disease at diagnosis and narrow the observed differences in stage at diagnosis between older black and white women.
Author and Article Information
From Boston Medical Center and Boston University School of Management, Boston, Massachusetts; and Tulane University School of Public Health and Tropical Medicine, New Orleans, Louisiana.
ARTICLE
Mammography Use Helps To Explain Differences in Breast Cancer Stage at Diagnosis between Older Black and White Women
2 mammographies done at least 10 months apart), or peri-diagnosis users (mammography done only within 3 months before diagnosis). Information on mammography use was linked with SEER data to determine cancer stage at diagnosis. Stage was classified as early (in situ or local) or late (regional or distant).
Acknowledgments: This study used the Linked Medicare-Tumor Registry Database. The interpretation and reporting of these data are the sole responsibility of the authors. The authors acknowledge the efforts of several groups responsible for creating and disseminating the Linked Database, including the Applied Research Branch, Division of Cancer Prevention and Control, National Cancer Institute; the Office of Research and Demonstrations and the Bureau of Data Management and Strategy, Health Care Financing Administration; Information Management Services, Inc.; and the Surveillance, Epidemiology, and End Results (SEER) program tumor registries.
Grant Support: In part by U.S. Army Medical Research and Materiel Command Breast Cancer Fellowship Program Grant DMAD-17-96-1-6011 and by Health Care Financing Dissertation Fellowship Grant 30-P-90665/6.
Requests for Reprints: Ellen P. McCarthy, PhD, Division of General Medicine and Primary Care, Department of Medicine, Beth Israel Deaconess Medical Center, 330 Brookline Avenue, Libby-326, Boston, MA 02215.
Current Author Addresses: Drs. McCarthy and Burns: Division of General Medicine and Primary Care, Department of Medicine, Beth Israel Deaconess Medical Center, 330 Brookline Avenue, Libby-326, Boston, MA 02215.
This article has been cited by other articles:
|
|
 |
|
  E. R. Smith, S. A. Adams, I. P. Das, M. Bottai, J. Fulton, and J. R. Hebert Breast Cancer Survival among Economically Disadvantaged Women: The Influences of Delayed Diagnosis and Treatment on Mortality Cancer Epidemiol. Biomarkers Prev., October 1, 2008; 17(10): 2882 - 2890. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 B. D. Badgwell, S. H. Giordano, Z. Z. Duan, S. Fang, I. Bedrosian, H. M. Kuerer, S. E. Singletary, K. K. Hunt, G. N. Hortobagyi, and G. Babiera Mammography Before Diagnosis Among Women Age 80 Years and Older With Breast Cancer J. Clin. Oncol., May 20, 2008; 26(15): 2482 - 2488. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 A. J. Greenstein, V. R. Litle, S. J. Swanson, C. M. Divino, S. Packer, T. G. McGinn, and J. P. Wisnivesky Racial Disparities in Esophageal Cancer Treatment and Outcomes Ann. Surg. Oncol., March 1, 2008; 15(3): 881 - 888. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
D. J. Blackman and C. M. Masi Racial and Ethnic Disparities in Breast Cancer Mortality: Are We Doing Enough to Address the Root Causes? J. Clin. Oncol., May 10, 2006; 24(14): 2170 - 2178. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 R. Smith-Bindman, D. L. Miglioretti, N. Lurie, L. Abraham, R. B. Barbash, J. Strzelczyk, M. Dignan, W. E. Barlow, C. M. Beasley, and K. Kerlikowske Does utilization of screening mammography explain racial and ethnic differences in breast cancer? Ann Intern Med, April 18, 2006; 144(8): 541 - 553. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 L.-M. Baldwin, S. A. Dobie, K. Billingsley, Y. Cai, G. E. Wright, J. A. Dominitz, W. Barlow, J. L. Warren, and S. H. Taplin Explaining Black-White Differences in Receipt of Recommended Colon Cancer Treatment J Natl Cancer Inst, August 17, 2005; 97(16): 1211 - 1220. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
R. T. Chlebowski, Z. Chen, G. L. Anderson, T. Rohan, A. Aragaki, D. Lane, N. C. Dolan, E. D. Paskett, A. McTiernan, F. A. Hubbell, et al. Ethnicity and Breast Cancer: Factors Influencing Differences in Incidence and Outcome J Natl Cancer Inst, March 16, 2005; 97(6): 439 - 448. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 L. A. Newman Breast Cancer in African-American Women Oncologist, January 1, 2005; 10(1): 1 - 14. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 K. F. Aaron and C. M. Clancy Improving Quality and Reducing Disparities: Toward a Common Pathway JAMA, February 26, 2003; 289(8): 1033 - 1034. [Full Text] [PDF]
|
|
|
|
 |
|
 C. I. Li, K. E. Malone, and J. R. Daling Differences in Breast Cancer Stage, Treatment, and Survival by Race and Ethnicity Arch Intern Med, January 13, 2003; 163(1): 49 - 56. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J. L. Malin, M. A. Schuster, K. A. Kahn, and R. H. Brook Quality of Breast Cancer Care: What Do We Know? J. Clin. Oncol., November 1, 2002; 20(21): 4381 - 4393. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 J. A. Earp, E. Eng, M. S. O'Malley, M. Altpeter, G. Rauscher, L. Mayne, H. F. Mathews, K. S. Lynch, and B. Qaqish Increasing Use of Mammography Among Older, Rural African American Women: Results From a Community Trial Am J Public Health, April 1, 2002; 92(4): 646 - 654. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 C. Bishop, J. A. Earp, E. Eng, and K. S. Lynch Implementing a Natural Helper Lay Health Advisor Program: Lessons Learned from Unplanned Events Health Promot Pract, April 1, 2002; 3(2): 233 - 244. [Abstract] [PDF]
|
|
|
|
|
|
S. S. Merkin, L. Stevenson, and N. Powe Geographic Socioeconomic Status, Race, and Advanced-Stage Breast Cancer in New York City Am J Public Health, January 1, 2002; 92(1): 64 - 70. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 P. G. Moorman, B. A. Jones, R. C. Millikan, I. J. Hall, and B. Newman Race, Anthropometric Factors, and Stage at Diagnosis of Breast Cancer Am. J. Epidemiol., February 1, 2001; 153(3): 284 - 291. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 D. M. Cummings, L. Whetstone, A. Shende, and D. Weismiller Predictors of Screening Mammography: Implications for Office Practice Arch Fam Med, September 1, 2000; 9(9): 870 - 875. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. Extermann, L. Balducci, and G. H. Lyman What Threshold for Adjuvant Therapy in Older Breast Cancer Patients? J. Clin. Oncol., April 1, 2000; 18(8): 1709 - 1717. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
K. C. Chu, R. E. Tarone, and O. W. Brawley Breast Cancer Trends of Black Women Compared With White Women Arch Fam Med, November 1, 1999; 8(6): 521 - 528. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 Low Use of Mammography, Race, and Breast Cancer Journal Watch Women's Health, June 1, 1998; 1998(601): 19 - 19. [Full Text]
|
|
|
|
 |
|
 Less Mammography Use Explains Later Breast Cancer Diagnosis in Black Women Journal Watch (General), May 8, 1998; 1998(508): 1 - 1. [Full Text]
|
|
Article
