BREAST-CANCER SCREENING PRACTICES AMONG BLACK, HISPANIC, AND WHITE WOMEN - REASSESSING DIFFERENCES

Introduction: We examine racial and ethnic variations in use of screen ing mammography. We first review recent literature on Blacks', Hispani cs', and non-Hispanic Whites' mammography use. Here we extend that bod y of literature through use of a comprehensive national database and d iscussion of the implications of race- and nonrace-stratified mammogra phy modeling. Methods: Data were extrapolated from the 1990 National H ealth Interview Survey. Using the Transtheoretical Model as a conceptu al guide, we derived a woman's stage of mammography adoption by integr ating screening history with intention to have a future mammogram. The outcome variables included (1) not being screened at regular interval s and (2) not intending to have a mammogram in the future. Analyses we re stratified by three groups: Blacks, Hispanics, and non-Hispanic Whi tes. Results: The results from the multiple logistic regressions demon strate that race continues to be a factor influencing mammography use. Across all three groups, women who reported less regular cancer scree ning by clinical breast exam (CBE), Pap smear testing, or breast self- examination were less frequent users of mammography. However, the magn itude of the associations varied for the groups being compared. The fi ndings also demonstrate that there were unique factors associated with not being screened routinely and not intending to have a mammogram in the future for all three racial/ethnic groups. Conclusions: Researche rs must give explicit attention, both empirically and methodologically , to how race and ethnicity interact with sociodemographic factors, he alth practices, and access to health care to refine our understanding of barriers to breast cancer screening. Common barriers to routine scr eening may be perceived differently by Black, Hispanic, and White wome n and may contribute to underuse of mammography in distinct ways.