Consedine 2012

 

Year: 2012

Title: The demographic, system, and psychosocial origins of mammographic screening disparities: Prediction of initiation versus maintenance screening among immigrant and non-immigrant women

Country: United States

Age: Adult Only

Sex: Female

Population: Immigrants

Care Setting: Outpatient Ambulatory and Primary Care

Clinical Setting: Breast Cancer Screening

Data Level: Regional

Data Type: Private Survey

Data Source: Local data

Conclusion: Disparities In Some Minority Groups

Health OutComes Reported: No

Mitigation: No

Free Text Conclusion: Certain immigrant populations are less likely to initiate and maintain breast cancer screening controlling for insurance and other factors.

Abstract: Disparities in breast screening are well documented. Less clear are differences within groups of immigrant and non-immigrant minority women or differences in adherence to mammography guidelines over time. A sample of 1,364 immigrant and non-immigrant women (African American, English Caribbean, Haitian, Dominican, Eastern European, and European American) were recruited using a stratified cluster-sampling plan. In addition to measuring established predictors of screening, women reported mammography frequency in the last 10 years and were (per ACS guidelines at the time) categorized as never, sub-optimal (<1 screen/year), or adherent (1+ screens/year) screeners. Multinomial logistic regression showed that while ethnicity infrequently predicted the never versus sub-optimal comparison, English Caribbean, Haitian, and Eastern European women were less likely to screen systematically over time. Demographics did not predict the never versus sub-optimal distinction; only regular physician, annual exam, physician recommendation, and cancer worry showed effects. However, the adherent categorization was predicted by demographics, was less likely among women without insurance, a regular physician, or an annual exam, and more likely among women reporting certain patterns of emotion (low embarrassment and greater worry). Because regular screening is crucial to breast health, there is a clear need to consider patterns of screening among immigrant and non-immigrant women as well as whether the variables predicting the initiation of screening are distinct from those predicting systematic screening over time.