Use of screening mammography and clinical breast examinations among black, Hispanic, and white women

Background. Breast cancer screening can be an effective tool in the early detection of breast cancer but remains underused by women in the United States. Methods, We analyzed data from 22,657 women (2,068 black women, 707 Hispanic women, and 19,882 white women) who participated in the 1990 Behavioral Risk Factor Surveillance state-based telephone survey. Using the recommended guidelines of the American Cancer Society for breast cancer screening, we examined utilization rates by demographic and selected variables, stratified by ethnic groups. Results. Of the women included in the analysis, 47% of both black and Hispanic women and 50% of white women reported having had a recent mammogram, and 68% of black women, 59% of Hispanic women, and 66% of white women reported having had a recent clinical breast examination (CBE). Important predictors of the use of breast cancer screening procedures for each group were having had a routine examination in the past year, having seen an obstetrician or gynecologist or specialist during the last routine examination, and more than a high school education. Conclusions. Many women are not having mammography and CBEs, Efforts to increase screening must focus on encouraging providers to use CBEs as a screening tool and to recommend mammography. Strategies should be developed to increase the use of these procedures among women, particularly those of low income and low education levels. (C) 1996 Academic Press, Inc.