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Mammography screening in African American women
Evaluating the research
Article first published online: 18 DEC 2002
Copyright © 2003 American Cancer Society
Supplement: Summit Meeting on Breast Cancer Among African American Women
Volume 97, Issue Supplement 1, pages 258–272, 1 January 2003
How to Cite
Jones, B. A., Patterson, E. A. and Calvocoressi, L. (2003), Mammography screening in African American women. Cancer, 97: 258–272. doi: 10.1002/cncr.11022
- Issue published online: 18 DEC 2002
- Article first published online: 18 DEC 2002
- Manuscript Received: 14 SEP 2002
- Manuscript Accepted: 14 SEP 2002
- National Cancer Institute
- breast neoplasms;
- African Americans;
Notwithstanding some controversy regarding the benefits of screening mammography, it is generally assumed that the effects are the same for women of all race/ethnic groups. Yet evidence for its efficacy from clinical trial studies comes primarily from the study of white women. It is likely that mammography is equally efficacious in white and African American women when applied under relatively optimal clinical trial conditions, but in actual practice African Americans may not be receiving equal benefit, as reflected in their later stage at diagnosis and greater mortality.
Initial searches of Medline using search terms related to screening mammography, race, and other selected topics were supplemented with national data that are routinely published for cancer surveillance. Factors that potentially compromise the benefits of mammography as it is delivered in the current health care system to African American women were examined.
While there have been significant improvements in mammography screening utilization, observational data suggest that African American women may still not be receiving the full benefit. Potential explanatory factors include low use of repeat screening, inadequate followup for abnormal exams, higher prevalence of obesity and, possibly, breast density, and other biologic factors that contribute to younger age at diagnosis.
Further study of biologic factors that may contribute to limited mammography efficacy and poorer breast cancer outcomes in African American women is needed. In addition, strategies to increase repeat mammography screening and to ensure that women obtain needed followup of abnormal mammograms may increase early detection and improve survival among African Americans. Notwithstanding earlier age at diagnosis for African American women, mammography screening before age 40 years is not recommended, but screening of women aged 40–49 years is particularly critical. Cancer 2003;97(1 Suppl):258–72. © 2003 American Cancer Society.
An erratum to this article is published in Cancer (2003) 97(8) 2047.