MAMMOGRAPHY SCREENING AND BREAST-CANCER TUMOR SIZE IN FEMALE MEMBERS OF A MANAGED CARE ORGANIZATION

A study of temporal trends in mammography screening and changes in sta ge of disease at diagnosis was conducted among Hispanic and non-Hispan ic white female members of the Lovelace Health Plan, Flexcare Plan, an d Lovelace Senior Plan/Senior Options (LHP), a managed care organizati on. Two-year screening rates for female members ages 50-74 years were calculated for 1989-1996, From 1989-1996, mammography screening rates for non-Hispanic white female members increased from 65.5 to 71.6%, al though this was not a statistically significant increase. Screening ra tes for Hispanic female members also increased from 50.6 to 62.7%, but they were significantly lower than for non-Hispanic white women. All breast cancers occurring among LHP female members ages 40-73 years wer e also identified for this same time period. A logistic regression mod el adjusting for age, gear of diagnosis, ethnicity, and duration of en rollment prior to diagnosis found that statistically significant predi ctors of more advanced stage of disease at diagnosis included young ag e, diagnosis after 1991 for non-Hispanic white women, and diagnosis pr ior to 1992 for Hispanic women. Longer duration of enrollment prior to diagnosis was predictive of lower stage of disease, but the odds rati o was not statistically significant, For the time period 1992-1996, Hi spanic women with breast cancer were more than twice as likely to have advanced stage of breast cancer compared with non-Hispanic white wome n (odds ratio, 2,12).