Abstract
BackgroundBreast cancer screening rates have increased over time in the United States. However actual screening rates appear to be lower among black women compared with white women.PurposeTo assess determinants of breast cancer screening among women in Michigan USA, focusing on individual and neighborhood socio-economic status and healthcare access.MethodsData from 1163 women ages 50-74 years who participated in the 2008 Michigan Special Cancer Behavioral Risk Factor Survey were analyzed. County-level SES and healthcare access were obtained from the Area Resource File. Multilevel logistic regression models were fit using SAS Proc Glimmix to account for clustering of individual observations by county. Separate models were fit for each of the two outcomes of interest; mammography screening and clinical breast examination. For each outcome, two sequential models were fit; a model including individual level covariates and a model including county level covariates.ResultsAfter adjusting for misclassification bias, overall cancer screening rates were lower than reported by survey respondents; black women had lower mammography screening rates but higher clinical breast examination rates than white women. However, after adjusting for other individual level variables, race was not a significant predictor of screening. Having health insurance or a usual healthcare provider were the most important predictors of cancer screening.DiscussionAccess to healthcare is important to ensuring appropriate cancer screening among women in Michigan.
Highlights
The breast cancer incidence-mortality disparity has been described as the disproportionately higher mortality rate among black women compared with whites in the United States but higher incidence among whites compared with blacks [1,2,3,4,5,6]
Access to healthcare is important to ensuring appropriate cancer screening among women in Michigan
Potential individual and neighborhood level determinants of adequate breast cancer screening among women residing in Michigan, USA were explored in this analysis
Summary
The breast cancer incidence-mortality disparity has been described as the disproportionately higher mortality rate among black women compared with whites in the United States but higher incidence among whites compared with blacks [1,2,3,4,5,6]. In the United States, recent survival studies show that black women are more likely to be diagnosed with breast cancer at advanced stages compared with white women [15,18,19,21], and are less likely to have timely follow-up of abnormal mammography findings [22,23,24]. This suggests that the observed incidence-mortality paradox may be due to the lack of adequate mammography screening and diagnostic follow-up among black women [21]. Purpose: To assess determinants of breast cancer screening among women in Michigan USA, focusing on individual and neighborhood socio-economic status and healthcare access
Sign-in/Register to view highlights & summary 
Published Version (
Free)
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call