Examining Breast Cancer Screening Behavior Among Southern Black Women After the 2009 US Preventive Services Task Force Mammography Guideline Revisions
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Updated United States Preventive Services Task Force (USPSTF) and American Cancer Society mammography screening recommendations push for increased age of initiation and lengthened breast cancer screening intervals. These changes have implications for the reduction of breast cancer mortality in Black women. The purpose of this study was to examine breast cancer screening behavior in a cohort of Southern Black women after the release of the 2009 USPSTF recommendations. Surveys assessing cancer screening information were collected from members of Black churches between 2006 and 2013. The sample was restricted to women aged 40 to 74 years, who did not report a breast cancer diagnosis, or a recent diagnostic mammogram (n = 789). Percentages of women ever completing a mammogram (age 40–49) and annual mammography (age 50–74) in 2006–2009 and 2010–2013 were compared using chi-square statistics. Logistic regression models were fit to determine the predictors of adherence to pre-2010 screening guidelines. No significant changes in mammography rates were found for women in the 40–49 age group (X2 = 0.42, p = 0.52) nor for those in the 50–74 age group (X2 = 0.67, p = 0.41). Completing an annual clinical breast exam was a significant predictor of adherence to pre-2010 screening guidelines for both age groups (OR 19.86 and OR 33.27 respectively) and participation in education sessions (OR 4.26). Stability in mammography behavior may be a result of PCP’s advice, or community activities grounded pre-2010 screening recommendations. More research is needed to understand how clinical interactions and community-based efforts shape Black women’s screening knowledge and practices.
KeywordsEarly detection of cancer Guideline adherence Mammography African Americans Breast neoplasms
We would like to thank Deloris Williams RN, BSN, MSN, PhD, Wanda Green, and the regional coordinators of the State Baptist Young Woman’s Auxiliary of the Women’s Baptist Educational and Missionary Convention of South Carolina and the participating churches for their work assisting with this study. DEF had full access to the data analyzed for this article and takes responsibility for the integrity of the data and the accuracy of the data analysis.
This work was a part of the South Carolina Cancer Disparities Community Network (SCCDCN). The SCCDCN was supported by [Grant Nos. U01CA114601-05S2 (SCCDCN-1; 2005–2010); U54CA153461 (SCCDCN-II; 2010–2015); U54CA153461-04S2/ U54CA153461-05S1] from the Center to Reduce Cancer Health Disparities of the National Cancer Institute. The content is solely the responsibility of the authors and does not represent the official views of the National Institutes of Health or the National Cancer Institute.
Compliance with Ethical Standards
Conflict of interest
The authors declare that they have no conflict of interest.
- 3.Oeffinger, K. C., Fontham, E. T. H., Etzioni, R., Herzig, A., Michaelson, J. S., Shih, Y.-C. T., et al. (2015). Breast cancer screening for women at average risk: 2015 Guideline update from the American Cancer Society. JAMA, 314(15), 1599. https://doi.org/10.1001/jama.2015.12783.CrossRefPubMedPubMedCentralGoogle Scholar
- 4.Shoemaker, M. L., White, M. C., Wu, M., Weir, H. K., & Romieu, I. (2018). Differences in breast cancer incidence among young women aged 20–49 years by stage and tumor characteristics, age, race, and ethnicity, 2004–2013. Breast Cancer Research and Treatment, 169(3), 595–606. https://doi.org/10.1007/s10549-018-4699-9.CrossRefPubMedPubMedCentralGoogle Scholar
- 6.Leitch, A. M., Dodd, G. D., Costanza, M., Linver, M., Pressman, P., McGinnis, L., & Smith, R. A. (1997). American Cancer Society guidelines for the early detection of breast cancer: update 1997. CA: A Cancer Journal for Clinicians, 47(3), 150–153.Google Scholar
- 7.Smith, R. A., Saslow, D., Sawyer, K. A., Burke, W., Costanza, M. E., Evans, W., et al. (2003). American Cancer Society guidelines for breast cancer screening: update 2003. CA: A Cancer Journal for Clinicians, 53(3), 141–169.Google Scholar
- 8.Humphrey, L. L., Helfand, M., Chan, B. K. S., & Woolf, S. H. (2002). Breast cancer screening: A summary of the evidence for the U.S. Preventive Services Task Force. Annals of Internal Medicine, 137(5_Part_1), 347–360. https://doi.org/10.7326/0003-4819-137-5_Part_1-200209030-00012.CrossRefPubMedGoogle Scholar
- 10.Kolata, G. (2009, November 16). In reversal, panel urges mammograms at 50, not 40. The New York Times. Retrieved July 14, 2016, from http://www.nytimes.com/2009/11/17/health/17cancer.html.
- 11.Stein, R. (2009, November 17). Federal panel recommends reducing number of mammograms. The Washington Post. Retrieved July 14, 2016, from http://www.washingtonpost.com/wp-dyn/content/article/2009/11/16/AR2009111602822.html.
- 12.Port, S. R. D., Elisa, R., & Sonnenblick, E. B. (2015, October 28). Why the annual mammogram matters. The New York Times. Retrieved July 14, 2016, from http://www.nytimes.com/2015/10/29/opinion/why-the-annual-mammogram-matters.html.
- 13.Sifferlin, A. (2015, October 20). Mammogram guidelines get an overhaul—again. Time. Retrieved July 14, 2016, from http://time.com/4077672/american-cancer-society-mammography/.
- 16.Kiviniemi, M. T., & Hay, J. L. (2012). Awareness of the 2009 US Preventive Services Task Force recommended changes in mammography screening guidelines, accuracy of awareness, sources of knowledge about recommendations, and attitudes about updated screening guidelines in women ages 40–49 and 50+. BMC Public Health, 12(1), 899.CrossRefGoogle Scholar
- 18.Fedewa, S. A., de Moor, J. S., Ward, E. M., DeSantis, C. E., Sauer, G., Smith, A., R. A., & Jemal, A. (2016). Mammography use and physician recommendation after the 2009 U.S. Preventive Services Task Force Breast Cancer Screening Recommendations. American Journal of Preventive Medicine, 50(5), e123–e131. https://doi.org/10.1016/j.amepre.2015.10.010.CrossRefPubMedGoogle Scholar
- 21.Sprague, B. L., Bolton, K. C., Mace, J. L., Herschorn, S. D., James, T. A., Vacek, P. M., et al. (2014). Registry-based study of trends in breast cancer screening mammography before and after the 2009 US Preventive Services Task Force recommendations. Radiology, 270(2), 354–361.CrossRefPubMedPubMedCentralGoogle Scholar
- 22.Wang, A. T., Fan, J., Van Houten, H. K., Tilburt, J. C., Stout, N. K., Montori, V. M., & Shah, N. D. (2014). Impact of the 2009 US Preventive Services Task Force Guidelines on screening mammography rates on women in their 40 s. PLoS ONE, 9(3), e91399. https://doi.org/10.1371/journal.pone.0091399.CrossRefPubMedPubMedCentralGoogle Scholar
- 24.Finney Rutten, L. J., Ebbert, J. O., Jacobson, D. J., Squiers, L. B., Fan, C., Breitkopf, C. R., et al. (2014). Changes in U.S. Preventive Services Task Force Recommendations: Effect on mammography screening in Olmsted County, MN 2004–2013. Preventive Medicine, 69, 235–238. https://doi.org/10.1016/j.ypmed.2014.10.024.CrossRefPubMedGoogle Scholar
- 25.Jiang, M., Hughes, D. R., & Duszak, R. (2015). Screening mammography rates in the Medicare population before and after the 2009 U.S. Preventive Services Task Force Guideline change: An interrupted time series analysis. Women’s Health Issues, 25(3), 239–245. https://doi.org/10.1016/j.whi.2015.03.002.CrossRefPubMedGoogle Scholar
- 28.Boggs, D. A., Rosenberg, L., Adams-Campbell, L. L., & Palmer, J. R. (2015). Prospective approach to breast cancer risk prediction in African American women: The Black Women’s Health Study Model. Journal of Clinical Oncology, 33(9), 1038–1044. https://doi.org/10.1200/JCO.2014.57.2750.CrossRefPubMedPubMedCentralGoogle Scholar
- 30.McCullough, M. L., Feigelson, H. S., Diver, W. R., Patel, A. V., Thun, M. J., & Calle, E. E. (2005). Risk factors for fatal breast cancer in African-American Women and White Women in a large US prospective cohort. American Journal of Epidemiology, 162(8), 734–742. https://doi.org/10.1093/aje/kwi278.CrossRefPubMedGoogle Scholar
- 32.De Santis, C. E., Fedewa, S. A., Goding Sauer, A., Kramer, J. L., Smith, R. A., & Jemal, A. (2016). Breast cancer statistics, 2015: Convergence of incidence rates between black and white women: Breast Cancer Statistics, 2015. CA: A Cancer Journal for Clinicians, 66(1), 31–42. https://doi.org/10.3322/caac.21320.CrossRefGoogle Scholar
- 33.Richardson, L. C. (2016). Patterns and trends in age-specific Black-White differences in breast cancer incidence and mortality–United States, 1999–2014. MMWR. Morbidity and Mortality Weekly Report, 65. Retrieved December 19, 2016, from https://www.cdc.gov/mmwr/volumes/65/wr/mm6540a1.htm.
- 34.Sighoko, D., Fackenthal, J. D., & Hainaut, P. (2015). Changes in the pattern of breast cancer burden among African American women: Evidence based on 29 states and District of Columbia during 1998 to 2010. Annals of Epidemiology, 25(1), 15–25.e10. https://doi.org/10.1016/j.annepidem.2014.09.006.CrossRefPubMedGoogle Scholar
- 39.Musa, D., Schulz, R., Harris, R., Silverman, M., & Thomas, S. B. (2009). Trust in the Health Care System and the Use of Preventive Health Services by Older Black and White Adults. American Journal of Public Health, 99(7), 1293–1299. https://doi.org/10.2105/AJPH.2007.123927.CrossRefPubMedPubMedCentralGoogle Scholar
- 40.Richardson, A., Allen, J. A., Xiao, H., & Vallone, D. (2012). Effects of Race/Ethnicity and Socioeconomic Status on Health Information-Seeking, Confidence, and Trust. Journal of Health Care for the Poor and Underserved, 23(4), 1477–1493. https://doi.org/10.1353/hpu.2012.0181.CrossRefPubMedGoogle Scholar
- 41.Institute of Medicine. (2003). Unequal treatment: Confronting racial and ethnic disparities in health care. Retrieved July 14, 2016, from The National Academies Press website: http://www.nap.edu/openbook.php?record_id=10260&page=R3.
- 42.Farr, D. E., Brandt, H. M., Comer, K. D., Jackson, D. D., Pandya, K., Friedman, D. B., et al. (2015). Cancer research participation beliefs and behaviors of a southern Black population: A quantitative analysis of the role of structural factors in cancer research participation. Journal of Cancer Education, 30(3), 522–520. https://doi.org/10.1007/s13187-014-0749-0.CrossRefPubMedPubMedCentralGoogle Scholar
- 43.Centers for Disease Control and Prevention (CDC). (2006). Behavioral Risk Factor Surveillance System Survey Questionaire. Atlanta: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention.Google Scholar
- 44.Ingram, D., & Franco, S. (2012). NCHS urban-rural classification scheme for counties. Vital and Health Statistics. Series 2, Data Evaluation and Methods Research, (154, 1–65.Google Scholar
- 45.StataCorp. (2013). Stata Statistical Software: Release 13. College Station: StataCorp LP.Google Scholar
- 48.Onega, T., Tosteson, T. D., Weiss, J., Haas, J. S., Goodrich, M., DiFlorio, R., et al. (2018). Multi-level influences on breast cancer screening in primary care. Journal of General Internal Medicine, 33(10), 1729–1737. https://doi.org/10.1007/s11606-018-4560-1.CrossRefPubMedPubMedCentralGoogle Scholar
- 49.Gonzales, F. A., Taplin, S. H., Yu, M., Breen, N., & Cronin, K. A. (2016). Receipt of mammography recommendations among White and non-White women before and after the 2009 United States Preventive Services Task Force recommendation change. Cancer Causes & Control. https://doi.org/10.1007/s10552-016-0775-9.CrossRefGoogle Scholar
- 50.O’Malley, M. S., Earp, J. A., Hawley, S. T., Schell, M. J., Mathews, H. F., & Mitchell, J. (2001). The association of race/ethnicity, socioeconomic status, and physician recomendation for mammography: Who gets the message about breast cancer screening? American Journal of Public Health, 91(1), 49–54.CrossRefGoogle Scholar
- 51.Braun, K. L., Stewart, S., Baquet, C., Berry-Bobovski, L., Blumenthal, D., Brandt, H. M., et al. (2015). The National Cancer Institute’s Community Networks Program Initiative to reduce cancer health disparities: Outcomes and lessons learned. Progress in Community Health Partnerships: Research, Education, and Action, 9(S), 21–32. https://doi.org/10.1353/cpr.2015.0017.CrossRefGoogle Scholar
- 52.Caban, M. E., & Adams-Huet, B. (2012). Meta-analysis: Culturally sensitive education and mammography uptake of minority women. Retrieved from http://cdn.intechopen.com/pdfs/31629/InTech-Meta_analysis_culturally_sensitive_education_and_mammography_uptake_of_minority_women.pdf.