OBJECTIVE: To examine racial differences in breast cancer screening in an H
MO that provides screening at no cost.
DESIGN: Retrospective cohort study of breast cancer screening among African
-American and white women. Breast cancer screening information was extracte
d from computerized medical records.
SETTING: A large HMO in New England.
PATIENTS/PARTICIPANTS: White and African-American women (N = 2,072) enrolle
d for at least 10 years in the HMO.
MAIN RESULTS: Primary care clinicians documented recommending a screening m
ammogram significantly more often for African Americans than whites (70% vs
64%; P < .001). During the 10-year period, on average, white women obtaine
d more mammograms (4.49 vs 3.93: P < .0001) and clinical breast examination
s (5.35 vs 4.92; P < .01) than African-American women. However, a woman's r
ace was no longer a statistically significant predictor of breast cancer sc
reening after adjustment for differences in age, estimated household income
, estrogen use, and body mass index (adjusted number of mammograms, 4.47 vs
4.25, P = .17; and adjusted number of clinical breast examinations, 5.35 v
s 5.31, P = .87).
CONCLUSIONS: In this HMO, African-American and white women obtained breast
cancer screening at similar rates. Comparisons with national data showed mu
ch higher screening rates in this HMO for both white and African-American w
omen.