The Demographic, System, and Psychosocial Origins of Mammographic Screening Disparities: Prediction of Initiation Versus Maintenance Screening Among Immigrant and Non-Immigrant Women Authors
First Online: 09 September 2011 DOI:
Cite this article as: Consedine, N.S. J Immigrant Minority Health (2012) 14: 570. doi:10.1007/s10903-011-9524-z 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.
Keywords Mammography Ethnic disparities Immigrant health Minority health Psychosocial factors References
ACS. Cancer facts and figures, 2010. Atlanta: American Cancer Society; 2010.
de Koning HJ. Mammographic screening: evidence from randomized controlled trials. Ann Oncol. 2003;14:1185–9.
Humphrey LL, Helfand M, Chan BKS, Woolf SH. Breast cancer screening: a summary of the evidence for the US preventive task force. Ann Intern Med. 2002;137(1):347–60.
Clark MA, Rakowski W, Bonacore LB. Repeat mammography: prevalence estimates and considerations for assessment. Ann Behav Med. 2003;26(3):201–11.
Rosenberg L, Wise LA, Palmer JR, Horton NJ, Adams-Campbell LL. A multilevel study of socioeconomic predictors of regular mammography use among African-American women. Cancer Epidemiol Biomarkers Prev. 2005;14(11):2628–33.
Rakowski W, Breen N, Meissner H, Rimer BK, Vernon SW, Clark MA, et al. Prevalence and correlates of repeat mammography among women aged 55–79 in the Year 2000 National Health Interview Survey. Prev Med. 2004;39(1):1–10.
Rakowski W, Meissner H, Vernon SW, Breen N, Rimer B, Clark MA. Correlates of repeat and recent mammography for women ages 45 to 75 in the 2002 to 2003 Health Information National Trends Survey (HINTS 2003). Cancer Epidemiol Biomarkers Prev. 2006;15(11):2093–101.
Boudreau DM, Luce CL, Ludman E, Bonomi AE, Fishman PA. Concordance of population-based estimates of mammography screening. Prev Med. 2007;45(4):262–6.
Bobo JK, Shapiro JA, Schulman J, Wolters CL. On-schedule mammography rescreening in the National Breast and Cervical Cancer Early Detection Program. Cancer Epidemiol Biomarkers Prev. 2004;3:620–30.
Hansen JP, Knapp PA, Newcomb PA. Mammography in a health maintenance organization. Am J Public Health. 1991;81(11):1489–90.
Michielutte R, Diseker RA. Racial differences in knowledge of cancer: a pilot study. Soc Sci Med. 1982;16:245–52.
Miller LY, Hailey BJ. Cancer anxiety and breast cancer screening in African American women: a preliminary study. Women’s Health Int. 1994;4(3):170–4.
Trontell AE, Franey EW. Use of mammography services by women aged great-than-or-equal-to-65-years enrolled in Medicare—United States, 1991–1993. J Am Med Assoc. 1995;274(18):1420.
Burns RB, McCarthy EP, Freund KM, Marwill SL, Schwartz M, Ash A, et al. Black women receive less mammography even with similar use of primary care. Ann Intern Med. 1996;125:173–82.
Anderson LM, May DS. Has the use of cervical, breast, and colorectal cancer screening increased in the United States? Am J Public Health. 1995;85(6):840–2.
Breen N, Kessler L. Changes in the use of screening mammography: evidence from the 1987 and 1990 National Health Interview Surveys. Am J Public Health. 1994;84:62–7.
Glanz K, Resch N, Lerman C, Rimer BK. Black-white differences in factors influencing mammography use among employed female health maintenance organization members. Ethn Health. 1996;1(3):207–20.
Breen N, Waegner KK, Brown MI, Davis William W, Ballard-Barbash R. Progress in cancer screening from the 1987, 1992, and 1998 National Health Interview Surveys. J Natl Cancer Inst. 2001;93:1704–13.
Jones BA, Patterson EA, Calvocoressi L. Mammography screening in African American women: evaluating the research. Cancer. 2003;97(1):258–72.
Swan J, Breen N, Coates RJ, Rimer BK, Lee NC. Progress in cancer screening practices in the United States: results from the 2000 National Health Interview Survey. Cancer. 2003;97:1528–40.
Mandelblatt JS, Gold K, O’Malley AS, Taylor K, Cagney K, Hopkins JS, et al. Breast and cervix cancer screening among multiethnic women: role of age, health and source of care. Prev Med. 1999;28:418–25.
O’Malley AS, Kerner JF, Johnson L. Are we getting the message out to all? Health information sources and ethnicity. Am J Prev Med. 1999;17(3):198–202.
Frazier EL, Jiles RB, Mayberry R. Use of screening mammography and clinical breast examination among Black, Hispanic, and White women. Prev Med. 1996;25:118–25.
Alvidrez J, Azocar F, Miranda J. Demystifying the concept of ethnicity for psychotherapy researchers. J Consult Clin Psychol. 1996;64:903–8.
Kaplan JB, Bennett T. Use of race and ethnicity in biomedical publication. J Am Med Assoc. 2003;289:2709–16.
Thomas NM. Revisiting race/ethnicity as a variable in health research. Am J Public Health. 2002;92(2):156.
Magai C, Consedine NS, Conway F, Neugut AI, Culver C. Diversity matters: unique populations of older women and breast cancer screening. Cancer. 2004;100(11):2300–7.
Consedine NS, Magai C, Conway F. Predicting ethnic variation in adaptation to later life: styles of socioemotional functioning and constrained heterotypy. J Cross Cult Gerontol. 2004;19:95–129.
Williams DR, Lavizzo-Mourey R, Warren RC. The concept of race and health status in America. Public Health Rep. 1994;109:26–41.
Phillips AA, Jacobson JS, Magai C, Consedine NS, Horowitz-Mehler NC, Neugut AI. Cancer incidence and mortality in the Caribbean. Cancer Investig. 2007;25(6):476–83.
Schmidley AD, Gordon C. Profile of the foreign-born population in the United States: 1997. Washington: US Government Printing Office; 1999.
Yee BWK, Castro FG, Hammond WR, John R, Wyatt GE. Panel IV: risk-taking and abusive behaviors among ethnic minorities. Health Psychol. 1995;14:622–31.
Brown N, Naman P, Homel P, Fraser-White M, Clare R, Browne R. Assessment of preventive health knowledge and behaviors of African-American and Afro-Caribbean women in urban settings. J Natl Med Assoc. 2006;98(10):1644–51.
Garbers S, Chiasson MA. Breast cancer screening and health behaviors among African American and Caribbean women in New York City. J Health Care Poor Underserved. 2006;17(1):37–46.
David MM, Ko L, Prudent N, Green EH, Posner MA, Freund KM. Mammography use. J Natl Med Assoc. 2005;97(2):253–61.
Gorin SS, Heck JE. Cancer screening among Latino subgroups in the United States. Prev Med. 2005;40(5):515–26.
Soares D, Waters N, Frankson M, Kirlew K, Reid M. Sociocultural deterrents to mammographic screening in Jamaica. West Indian Med J. 2009;58(1):28–32.
Reyes-Ortiz CA, Freeman JL, Peláez M, Markides KS, Goodwin JS. Mammography use among older women of seven Latin American and Caribbean Cities. Prev Med. 2006;42(5):375–80.
Juon H-S, Kim M, Shankar S, Han W. Predictors of adherence to screening mammography among Korean American women. Prev Med. 2004;39(3):474–81.
Roetzheim RG, Pal N, Tennant C, Voti L, Ayanian JZ, Schwabe A, et al. Effects of health insurance and race on early detection of cancer. J Natl Cancer Inst. 1999;91(16):1409–15.
May DS, Kiefe CI, Funkhouser E, Fouad MN. Compliance with mammography guidelines: physician recommendation and patient adherence. Prev Med. 1999;28(4):386–94.
Russell KM, Champion VL, Skinner CS. Psychosocial factors related to repeat mammography screening over 5 years in African American women. Cancer Nurs. 2006;29(3):236–43.
Consedine NS, Magai C, Neugut AI. The contribution of emotional characteristics to breast cancer screening among women from six ethnic groups. Prev Med. 2004;38(1):64–77.
Consedine NS, Magai C, Horton D, Neugut AI, Gillespie M. Health belief model factors in mammography screening: testing for interactions among subpopulations of Caribbean women. Ethn Dis. 2005;15(3):444–52.
Consedine NS, Ladwig I, Reddig MK, Broadbent EA. The many faeces of colorectal cancer screening embarrassment: preliminary psychometric development and links to screening outcome. Br J Health Psychol. 2011;16:559–79.
Consedine NS, Magai C, Krivoshekova YS, Ryzewicz L, Neugut AI. Fear, anxiety, worry, and breast cancer screening behavior: a critical review. Cancer Epidemiology. Biomarkers Prev. 2004;13(4):501–10.
Gierisch JM, O’Neill SC, Rimer BK, DeFrank JT, Bowling JM, Skinner CS. Factors associated with annual-interval mammography for women in their 40s. Cancer Epidemiol. 2009;33(1):72–8.
Powe BD. Fatalism among elderly African Americans. Cancer Nurs. 1995;18:385–92.
Powe BD, Finnie R. Cancer fatalism—the state of the science. Cancer Nurs. 2003;26(6):454–65.
Consedine NS, Christie MA, Neugut AI. Physician, affective, and cognitive variables differentially predict “initiation” versus “maintenance” PSA screening profiles in diverse groups of men. Br J Health Psychol. 2009;14(2):303–22.
Gonzalez J, Consedine NS, McKiernan JM, Spencer BA. Barriers to initiation and maintenance of PSA screening among African American and Afro-Caribbean men. Urology. 2008;180(6):2403–8.
Drossaert CHC, Boer H, Seydel ER. Monitoring women’s experiences during three rounds of breast cancer screening: results from a longitudinal study. J Med Screen. 2002;9(4):168–75.
Drossaert CHC, Boer H, Seydel ER. Prospective study of the determinants of repeat attending and attendance patterns in breast cancer screening using the theory of planned behavior. Psychol Health. 2003;18:551–65.
Sandin B, Chorot P, Valiente RM, Lostao L, Santed MA. Adverse psychological effects in women attending a second-stage breast cancer screening. J Psychosom Res. 2002;52(5):303–9.
Margonoff PP, Folwarski J. Russian/Ukrainian families: an overview. In: McGoldrick M, Giordano J, Pearce JK, editors. Ethnicity and family therapy. 2nd ed. New York: Guilford; 1996. p. 672–85.
Cohen SS, Palmieri RT, Nyante SJ, Koralek DO, Kim S, Bradshaw P, et al. A review: obesity and screening for breast, cervical, and colorectal cancer in women. Cancer. 2008;112(9):1892–904.
Deurenberg P, Yap M, van Staveren WA. Body mass index and percent body fat: a meta-analysis among different ethnic groups. Int J Obes. 1998;22:1164–71.
Golden RR, Teresi JA, Gurland BJ. Development of indicator scales for the Comprehensive Assessment and Referral Evaluation (CARE). J Gerontol. 1984;39:138–46.
Teresi JA, Golden RR, Gurland BJ. Concurrent and predictive validity of indicator scales developed for the Comprehensive Assessment and Referral Evaluation interview schedule. J Gerontol. 1984;39:158–65.
Teresi JA, Golden RR, Gurland BJ, Wilder DE, Bennett RG. Construct validity of indicator scales developed from the Comprehensive Assessment and Referral Evaluation interview schedule. J Gerontol. 1984;39:147–57.
Gordon NP, Hiatt RA, Lampert DI. Concordance of self-reported data and medical records audit for six cancer screening procedures. J Natl Cancer Inst. 1993;85:566–70.
Force USPST. Screening for breast cancer: U.S. preventive services task force recommendation statement. Ann Intern Med. 2009;151(10):716–26.
Leitch AM, Dodd GD, Costanza M, Linver M, Pressman P, McGinnis L, et al. American Cancer Society guidelines for the early detection of breast cancer: update 1997. CA: Cancer J Clin. 1997;47(3):150–3.
Calvocoressi L, Sun A, Kasl SV, Claus EB, Jones BA. Mammography screening of women in their 40 s: impact of changes in screening guidelines. Cancer. 2008;112(3):473–80.
O’Malley AS, Kerner J, Johnson AE, Mandelblatt JS. Acculturation and breast cancer screening among Hispanic women in New York City. Am J Public Health. 1999;89(2):219–27.
Kudadjie-Gyamfi EK, Magai C. The influence of coping styles on mammography screening in a multiethnic sample. Cultur Divers Ethnic Minor Psychol. 2008;14(3):183–92.
Consedine NS, Krivoshekova YS, Harris CR. Bodily embarrassment and judgment concern as separable factors in the measurement of medical embarrassment: psychometric development and links to treatment-seeking outcomes. Br J Health Psychol. 2007;12(3):439–62.
Martin LL, Calle E, Wingo P, Heath C. Comparison of mammography and Pap test use from the 1987 and 1992 National Health Interview Surveys: are we closing the gaps? Am J Prev Med. 1996;12:82–90.
Edwards NI, Jones DA. Uptake of breast cancer screening in older women. Age Aging. 2000;29:131–5.
Davies HTO, Crombie IK, Tavakoli M. When can odds ratios mislead? Br Med J. 1998;316:989–91.
Peipins LA, Shapiro JA, Bobo JK, Berkowitz Z. Impact of women’s experiences during mammography on adherence to rescreening (United States). Cancer Causes Control. 2006;17(4):439–47.
Lerman C, Rimer BK, Trock B, Balshem A, Engstrom PF. Factors associated with repeat adherence to breast cancer screening. Prev Med. 1990;19:279–90.
Brown WM, Consedine NS, Magai C. Time spent in the United States and breast cancer screening behaviors among ethnically diverse immigrant women: evidence for acculturation? J Immigr Minor Health. 2006;8(4):347–58.
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