Breast Cancer Research and Treatment

, Volume 89, Issue 2, pp 111–118

Breast cancer screening barriers and mammography completion in older minority women

Report
  • 230 Downloads

Abstract

Objectives. The study tested a behavioral and structural barriers model of breast cancer screening, while seeking to determine age effects of behavioral barriers, in order to identify the factors that inhibit screening among older, minority women.

Methods. 405 older African-American women eligible for a federally funded cancer screening program were enrolled in the study. Participants were administered an intake questionnaire and followed for 3 months to determine mammography use.

Results. Three months after enrollment in the program, 79% had not received breast cancer screening. The oldest cohort had significantly lower rates of mammography (just 16% of screened women were ≥60, p<0.05). Behavioral barriers (knowledge/information deficits, cancer risk perception, cancer fears) inhibited mammography in the oldest group; their breast cancer information deficits included less knowledge of breast cancer risk, treatment, and survivability (all p<0.001).

Conclusions. Older women, with greater breast cancer risk than younger cohorts, should be targeted as a high need population for cancer screening. Even when financial and insurance barriers are removed mammography rates are 1/3 those of women <50. Since failure to be screened is related to knowledge and information barriers, health care providers have the potential to educate their older patients and subsequently increase the likelihood they will have regular cancer screening.

Keywords

age barriers breast cancer screening race 

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. Rimer BK: Audiences and messages for breast and cervical cancer screenings. In: Rimer BK (ed) Wellness Perspect 11(2): 13–39, 1995 Google Scholar
  2. The NCI Breast Cancer Screening Consortium: Screening mammography: a missed clinical opportunity? Results of the NCI Breast Cancer Screening Consortium and National Health Interview Survey Studies. JAMA 264: 54–58, 1990 Google Scholar
  3. Janz, NK, Schottenfeld, D, Doerr, K,  et al. 1997A two-step intervention to increase mammography among women aged 65 and olderAm J Public Health8716831686PubMedGoogle Scholar
  4. Stoddard, AM, Rimer, BK, Lane, D,  et al. 1998Underusers of mammogram screening: stage of adoption in 5 US Subpopulations. NCI Breast Cancer Screening ConsortPrev Med27478PubMedGoogle Scholar
  5. Burack, RC, George, J, Gurney, J 2000Mammography use among women as a function of age and patient involvement in decision-makingJ Am Geriatr Soc48817821PubMedGoogle Scholar
  6. Mandelblatt, JS, Yabroff, KR 2000Breast and cervical Cancer Screening for Older Women: Recommendations and Challenges for the 21st CenturyJ Am Med Women’s Assoc5521215Google Scholar
  7. O’Malley, MS, Earp, JAL, Harris, RP 1997Race and mammo-graphy use in two North Carolina CountriesAm J Pub Health87782786CrossRefPubMedGoogle Scholar
  8. Urban, N, Anderson, G, Peacock, S 1994Mammography screening: how important is cost as a barrier to useAm J. Pub Health845055PubMedGoogle Scholar
  9. Black, BL, Ades, TB 1994American cancer society urban demonstration projects: models for successful interventionSem Oncol Nurs1096103Google Scholar
  10. Hughes, C, Lerman, C, Lustbader, E 1996Ethnic differences in risk perception among women at increased risk for breast cancerBreast Cancer Res Treatment:402535Google Scholar
  11. Brown, D 1996Cancer Awareness and Behavior Study. Report. Center for Urban Studies, Wayne State UniversityDetroit, MIGoogle Scholar
  12. Suarez, L, Nichols, D, Roche, RA, Simpson, DM 1997Knowledge, behavior, and fears concerning breast and cervical cancer among older low-income Mexican-American womenAm J. Prev Med13137142PubMedGoogle Scholar
  13. Bradley, CJ, Given, CW, Roberts, C 2002Race, socioeconomic status, and breast cancer treatment and survivalJ Nat Cancer Inst94490496PubMedGoogle Scholar
  14. U.S. Department of Health and Human Services. Http://www.hhs.gov/news/press/2002pres/20020221.html.Google Scholar
  15. Smith-Bindman, R, Kerlikowske, K, Gebretsadik, T, Newman, J 2000Is screening mammography effective in elderly womenAm J Med108112119PubMedGoogle Scholar
  16. Gulitz, E, Bustillo-Hernandez, M, Kent, E 1998Missed cancer screening opportunities among older women: a reviewCancer Practice6289295PubMedGoogle Scholar
  17. Rimer, BK, Schildkraut, JM, Lerman, C, Lin, TH, Audrain, J 1996Participation in a women’s breast cancer risk counseling trialCancer7723482355PubMedGoogle Scholar
  18. Glanz, K, Resch, N, Lerman, C,  et al. 1992Factors associated with adherence to breast cancer screening among working womenJOM3410711078PubMedGoogle Scholar
  19. Lerman, C, Daly, M, Sands, C,  et al. 1993Psychological distress interferes with mammography adherence among women at risk for breast cancerJ Nat Cancer Inst8510741080PubMedGoogle Scholar
  20. Walter, LC, Covinsky, KE 2001Cancer screening in elderly patients: a framework for individualized decision makingJAMA28527502756PubMedGoogle Scholar
  21. Young RF, Hoey J, Stengle W: Delay/avoidance of mammography after breast cancer education. Meeting: Challenges of Comprehensive Cancer Control Sept. 7, 1999. Google Scholar
  22. Phillips, JM, Cohen, MZ, Moses, G 1999Breast cancer screening and African-American women: fear, fatalism, & silence.Oncology Nurs Forum26 561571Google Scholar
  23. McCaul, KD, Reid, PA, Rathge, RW, Martinson, B 1996Does concern about breast cancer inhibit or promote breast cancer screeningBasic Appl Soc Psych4183194Google Scholar
  24. Gail, MH, Brinton, LA, Byar, DP 1989Projecting individualized probabilities of developing breast cancer for white females examined annuallyJ Natl Cancer Inst8118791886PubMedGoogle Scholar
  25. Jacobellis, J, Cutter, G 2002Mammography screening and differences in stage of disease by race/ethnicityAm J Public Health9211441150PubMedCrossRefGoogle Scholar

Copyright information

© Springer 2005

Authors and Affiliations

  1. 1.Department of Community MedicineWayne State University School of Medicine, University Health CenterDetroitUSA
  2. 2.Department of Family Medicine and Karmanos Cancer InstituteWayne State UniversityUSA

Personalised recommendations