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Inadequate Communication Reduces Benefits of Mammogram Screening for Black Women
Black women may not get the full benefits of mammogram screenings because the results are not adequately communicated, according to a new study by Yale School of Public Health researchers in the March issue of American Journal of Public Health. To help reduce death and disability from breast cancer, the second most common cause of cancer death in American women, current guidelines recommend routine mammography screening for women aged 40 years and older. Despite widespread availability of mammography screening and relatively high self-reported screening rates in national survey data, racial disparities persist, in part resulting from diagnosis at later stages in black women when compared to white women. Beth A. Jones, Ph.D., M.P.H., associate professor in the Division of Chronic Disease Epidemiology at the Yale School of Public Health, led the study. In this community-based, two-year study of black and white women receiving mammograms in Connecticut, the investigators sought possible race-related differences in the screening mammography process. Jones, the Co-director of the Yale Comprehensive Cancer Center’s Office for the Elimination of Cancer Disparities, and colleagues compared self-reported mammogram results, collected by telephone interview, to results listed in the radiology record of 411 black women and 734 white women aged 40 to 79 who underwent screening in five hospital-based facilities in Connecticut. They examined whether black women were as likely as white women to self-report results that matched the mammography radiology report. A second objective was to determine how the results of a screening mammogram affected the communication of those results. Mammogram screening results were inadequately communicated to or understood by 14.5 percent of all women in the study. Of these, 12.5 percent reported they had not received their screening results, while the other 2.5 percent inaccurately reported their results. Black women were significantly more likely than white women to report never receiving their mammography results and/or to report results that differed from those reported in the medical record. “Although adequate communication of results of any screening test is always important, it was particularly concerning that abnormal mammogram results resulted in inadequate communication for black women but not for white women,” said Jones, who plans to conduct future studies to investigate racial differences in interactions with the healthcare system. “This may provide some insight into why communication of mammography results is more likely to be problematic for black women than for white women, particularly in the case of abnormal results,” she said. “In addition to logistical difficulties associated with lack of notification, it is likely that communication problems are tied to cultural and social dynamics that should be addressed to minimize racial disparities in mammography screening benefit,” Jones added. The study was supported by grants from the National Cancer Institute and the Agency for Healthcare Research and Quality. Other authors on the study included Kam Reams, Lisa Calvocoressi, Amy Dailey, Stanislav V. Kasl and Nancy M. Liston. Citation: American Journal of Public Health 97(3): 2007.
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