Rebecca Smith-Bindman, MD; Diana L. Miglioretti, PhD; Nicole Lurie, MD, MSPH; Linn Abraham, MS; Rachel Ballard Barbash, MD, MPH; Jodi Strzelczyk, PhD; Mark Dignan, PhD; William E. Barlow, PhD; Cherry M. Beasley, MS, RNCS; Karla Kerlikowske, MD
Grant Support: By the Mount Zion Dean's Account, the California Breast Cancer Research Program, The Department of Defense Congressionally Directed Medical Research Programs, The National Cancer Institute (K07 CA86032), and National Cancer Institute–funded Breast Cancer Surveillance Consortium cooperative agreements (U01CA63740, U01CA86076, U01CA86082, U01CA63736, U01CA70013, U01CA69976, U01CA63731, U01CA70040.)
Potential Financial Conflicts of Interest: None disclosed.
Requests for Single Reprints: Rebecca Smith-Bindman, MD, Department of Radiology, University of California, 1600 Divisadero Street, San Francisco, CA 94115; e-mail, Rebecca.Smith-Bindman@Radiology.UCSF.edu.
Current Author Addresses: Dr. Smith-Bindman: Department of Radiology, University of California, San Francisco, 1600 Divisadero Street, Room C250, San Francisco, CA 94115-1667.
Dr. Miglioretti and Ms. Abraham: Group Health Cooperative Center for Health Studies, 1730 Minor Avenue, Suite 1600, Seattle, WA 98101.
Dr. Lurie: RAND Corporation, 1200 South Hayes Street, Arlington, VA 22202.
Dr. Ballard Barbash: National Cancer Institute, Applied Research Program, Division of Cancer Control and Population Sciences, 6130 Executive Boulevard, Bethesda, MD 20892-7344.
Dr. Strzelczyk: School of Medicine, University of Colorado Health Sciences Center, Denver, CO 80262.
Dr. Dignan: University of Kentucky Prevention Research Center, 2365 Harrodsburg Road, Suite B100, Lexington, KY 40504.
Dr. Barlow: Cancer Research and Biostatistics, 1730 Minor Avenue, Suite 1900, Seattle WA 98101.
Ms. Beasley: Department of Nursing, University of North Carolina Pembroke, 1 University Drive, Pembroke, NC 28372.
Dr. Kerlikowske: General Internal Medicine Section, Department of Veterans Affairs, University of California, San Francisco, 4150 Clement Street, 111A1, San Francisco, CA 94121.
Author Contributions: Conception and design: R. Smith-Bindman, D.L. Miglioretti, N. Lurie, R.B. Barbash, J. Strzelczyk, M. Dignan, W.E. Barlow, K. Kerlikowske.
Analysis and interpretation of the data: R. Smith-Bindman, D.L. Miglioretti, N. Lurie, L. Abraham, R.B. Barbash, W.E. Barlow, K. Kerlikowske.
Drafting of the article: R. Smith-Bindman, D.L. Miglioretti, N. Lurie, R.B. Barbash, M. Dignan, W.E. Barlow, K. Kerlikowske.
Critical revision of the article for important intellectual content: R. Smith-Bindman, D.L. Miglioretti, N. Lurie, R.B. Barbash, J. Strzelczyk, M. Dignan, W.E. Barlow, C.M. Beasley, K. Kerlikowske.
Final approval of the article: R. Smith-Bindman, D.L. Miglioretti, N. Lurie, R.B. Barbash, M. Dignan, W.E. Barlow, C.M. Beasley, K. Kerlikowske.
Provision of study materials or patients: M. Dignan, K. Kerlikowske.
Statistical expertise: R. Smith-Bindman, D.L. Miglioretti, L. Abraham, W.E. Barlow.
Obtaining of funding: R. Smith-Bindman, N. Lurie, K. Kerlikowske, D.L. Miglioretti, W.E. Barlow.
Administrative, technical, or logistic support: R. Smith-Bindman.
Collection and assembly of data: R. Smith-Bindman, L. Abraham, C.M. Beasley, K. Kerlikowske, D.L. Miglioretti.
Smith-Bindman R., Miglioretti D., Lurie N., Abraham L., Barbash R., Strzelczyk J., Dignan M., Barlow W., Beasley C., Kerlikowske K.; Does Utilization of Screening Mammography Explain Racial and Ethnic Differences in Breast Cancer?. Ann Intern Med. 2006;144:541-553. doi: 10.7326/0003-4819-144-8-200604180-00004
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Published: Ann Intern Med. 2006;144(8):541-553.
Breast cancer mortality rates in the United States began to decrease in the 1990s (1) because of increased use of screening mammography and improved breast cancer treatment (2, 3). However, these decreases have primarily benefited non-Hispanic white women, whereas the mortality rate for breast cancer in African-American women changed little (1).
Although racial and ethnic differences in breast cancer mortality rates have been consistently documented (1, 4-9), reasons for the persistence of these differences have been difficult to ascertain (10). Possible explanations include differences in biological characteristics of tumors (11-13); patient characteristics, such as obesity, that may affect prognosis; mammography use (14, 15); timeliness and completeness of breast cancer diagnosis and treatment (16, 17); social factors, such as education, literacy, and cultural beliefs; and economic factors, such as income level and health insurance coverage, that might affect a patient's access to and choices for breast cancer screening and treatment (18-22). Stage at diagnosis, the strongest predictor of breast cancer survival (23), is proportionally higher in all non-Asian minority groups than in white women (8). Although minority women have historically undergone less mammography than white women (14), several recent surveys have found only small differences in mammography use between white and nonwhite women (24, 25). These observations raised doubt that tumors go undiagnosed until later stages in minority women because of infrequent breast cancer screening (26). However, the 2 most widely cited surveys of mammography use are based on self-report and only inquire about recent use, not adherence over time (24, 25).
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Hematology/Oncology, Breast Cancer, Prevention/Screening.
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Print ISSN: 0003-4819 | Online ISSN: 1539-3704
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