Received from the Division of General Internal Medicine, Rush Medical College, Rush University Medical Center and John Stroger Hospital, Chicago, Ill.
Disparities in Screening Mammography
Current Status, Interventions, and Implications
Article first published online: 27 FEB 2004
Journal of General Internal Medicine
Volume 19, Issue 2, pages 184–194, February 2004
How to Cite
Peek, M. E. and Han, J. H. (2004), Disparities in Screening Mammography. Journal of General Internal Medicine, 19: 184–194. doi: 10.1111/j.1525-1497.2004.30254.x
- Issue published online: 27 FEB 2004
- Article first published online: 27 FEB 2004
- health disparities;
- breast cancer;
- cancer screening
OBJECTIVE: This paper describes trends in screening mammography utilization over the past decade and assesses the remaining disparities in mammography use among medically underserved women. We also describe the barriers to mammography and report effective interventions to enhance utilization.
DESIGN: We reviewed medline and other databases as well as relevant bibliographies.
MAIN RESULTS: The United States has dramatically improved its use of screening mammography over the past decade, with increased rates observed in every demographic group. Disparities in screening mammography are decreasing among medically underserved populations but still persist among racial/ethnic minorities and low-income women. Additionally, uninsured women and those with no usual care have the lowest rates of reported mammogram use. However, despite apparent increases in mammogram utilization, there is growing evidence that limitations in the national survey databases lead to overestimations of mammogram use, particularly among low-income racial and ethnic minorities.
CONCLUSIONS: The United States may be farther from its national goals of screening mammography, particularly among underserved women, than current data suggests. We should continue to support those interventions that increase mammography use among the medically underserved by addressing the barriers such as cost, language and acculturation limitations, deficits in knowledge and cultural beliefs, literacy and health system barriers such as insurance and having a source regular of medical care. Addressing disparities in the diagnostic and cancer treatment process should also be a priority in order to affect significant change in health outcomes among the underserved.