Racial differences in breast cancer screening, knowledge and compliance

J Natl Med Assoc. 2003 Aug;95(8):693-701.


Background: Breast cancer is the second leading cause of cancer death among women in the United States. Although the incidence of breast cancer is 13% higher in white women, mortality in black women is 28% higher, due to histological and socioeconomic factors. Existing research regarding racial differences in compliance with breast cancer screening recommendations has found conflicting results.

Methods: Data on more than 4,500 women were taken from the 1992 National Health Interview Survey, a nationally representative, population-based sample survey. Logistic regression was used to estimate the relative odds of knowledge of breast self-exam (BSE) and mammograms, and compliance with BSE, clinical breast exams (CBE), and mammograms.

Results: Black women were less likely than white women to be aware of and use breast cancer screening tests. However, among women who were aware of screening tests, compliance was higher among black women. Women with low educational attainment, low cancer knowledge, and no usual source of care were less likely to be CBE or mammogram compliant. Socioeconomic differences were larger for the two clinical tests than for BSE.

Conclusions: Programs should inform women about cancer screening tests and remove barriers that hinder women from receiving clinical screening exams.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • African Americans
  • Aged
  • Breast Neoplasms / ethnology*
  • Breast Neoplasms / prevention & control*
  • Breast Self-Examination / standards
  • Breast Self-Examination / trends
  • Cross-Sectional Studies
  • European Continental Ancestry Group
  • Female
  • Health Knowledge, Attitudes, Practice
  • Humans
  • Logistic Models
  • Mammography / standards
  • Mammography / trends
  • Mass Screening / standards*
  • Mass Screening / trends
  • Middle Aged
  • Multivariate Analysis
  • Odds Ratio
  • Patient Compliance
  • Probability
  • Risk Assessment
  • Sensitivity and Specificity
  • Socioeconomic Factors
  • United States