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Review
. 2004 Feb;19(2):184-94.
doi: 10.1111/j.1525-1497.2004.30254.x.

Disparities in screening mammography. Current status, interventions and implications

Monica E Peek  1 , Jini H Han
Affiliations
Review

Disparities in screening mammography. Current status, interventions and implications

Monica E Peek et al. J Gen Intern Med. 2004 Feb.

Abstract

Objective: This paper describes trends in screening mammography utilization over the past decade and assesses the remaining disparities in mammography use among medically underserved women. We also describe the barriers to mammography and report effective interventions to enhance utilization.

Design: We reviewed medline and other databases as well as relevant bibliographies.

Main results: The United States has dramatically improved its use of screening mammography over the past decade, with increased rates observed in every demographic group. Disparities in screening mammography are decreasing among medically underserved populations but still persist among racial/ethnic minorities and low-income women. Additionally, uninsured women and those with no usual care have the lowest rates of reported mammogram use. However, despite apparent increases in mammogram utilization, there is growing evidence that limitations in the national survey databases lead to overestimations of mammogram use, particularly among low-income racial and ethnic minorities.

Conclusions: The United States may be farther from its national goals of screening mammography, particularly among underserved women, than current data suggests. We should continue to support those interventions that increase mammography use among the medically underserved by addressing the barriers such as cost, language and acculturation limitations, deficits in knowledge and cultural beliefs, literacy and health system barriers such as insurance and having a source regular of medical care. Addressing disparities in the diagnostic and cancer treatment process should also be a priority in order to affect significant change in health outcomes among the underserved.

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Figures

FIGURE 1
FIGURE 1
Breast cancer incidence and mortality by race and ethnicity—United States, 1992 to 1998. Data sources: American Cancer Society Surveillance Research 2001, National Cancer Institute SEER Program 2001, National Center for Health Statistics 2001.
FIGURE 2
FIGURE 2
Percentage of women aged > 40 years who reported ever having a mammogram, 38 states—Behavioral Risk Factor Surveillance System, 1989 to 1997.
See this image and copyright information in PMC

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