Aged, Breast Neoplasms/diagnosis, Breast Neoplasms/prevention & control, Confidence Intervals, Ethnic Groups, Female, Humans, Mammography/utilization, Mass Screening, Middle Aged, Minority Groups, Odds Ratio, Ontario, Patient Acceptance of Health Care, Patient Compliance, Practice Guidelines as Topic, Socioeconomic Factors
OBJECTIVE: This study investigates the association between ethnic minority status and receiving a screening mammogram within the past 2 years among American women over 50.
METHOD: The findings from 33 studies identified from interdisciplinary research databases (1980 to 2006) were synthesized. Separate pooled analyses compared white non-Hispanics to African Americans (28 outcomes), Hispanics (18 outcomes), and Asian/Pacific Islanders (10 outcomes).
RESULTS: Using the random effects model, results showed that African Americans were screened less than white non-Hispanics at a marginal level (OR 0.87, 95% CI 0.75, 1.00). Larger and significant discrepancies were observed for Hispanics (OR 0.65, 95% CI 0.50, 0.85) and Asian/Pacific Islanders (OR 0.63, 95% CI 0.39, 0.99) compared to white non-Hispanics. However, among studies controlling for socioeconomic status, ethnic differences in mammography screening were no longer significant for African Americans (OR 1.05, 95% CI 0.71, 1.76), Hispanics (OR 1.08, 95% CI 0.64, 1.93), or Asian/Pacific Islanders (OR 1.08, 95% CI 0.64, 1.93). Subgroup analyses further showed that geographical region, sampling method, and data collection strategy significantly impacted results.
CONCLUSIONS: This study found evidence that ethnic minority-screening mammography differences exist but were impacted by socioeconomic status. Implications for interpreting existing knowledge and future research needs are discussed.
Purc-Stephenson, Rebecca J. and Gorey, Kevin M.. (2008). Lower adherence to screening mammography guidelines among ethnic minority women in America: a meta-analytic review. Preventive Medicine, 46 (6), 479-488.