Screening mammography: does ethnicity influence patient preferences for higher recall rates given the potential for earlier detection of breast cancer?

Abstract

To prospectively survey the preferences of an underserved and predominantly minority population of women regarding their understanding of screening mammography, desire for recall and early detection, and willingness to continue with annual screening mammography once given a false-positive result. A total of 1011 women who were going to undergo mammography completed a HIPAA-compliant, Institutional Review Board-approved, validated survey in one of three languages: English, Spanish, or Haitian-Creole. Data were analyzed across three groups (ie, white, black, Hispanic) by using chi(2) analysis. Of 911 women included in the final analysis, 378 (41%) were white, 439 (48%) were black, and 94 (10%) were Hispanic. Income and education levels varied significantly across ethnicities (P < .0001). A higher percentage of white women (40%) correctly identified the sensitivity of mammography (P < .0001), while black (42%) and Hispanic (50%) participants thought mammography to have a higher sensitivity than it truly does. After a false-positive result, only 80% of black women and 71% of Hispanic women were likely to continue with screening in the future, compared with 93% of white women (P < .0001). Only 54% of black women and 59% of Hispanic women were willing to return for a second noninvasive procedure despite the possibility of a higher cancer detection rate, compared with 76% of white women (P < .0001). Black women (53%) were also more reluctant to be recalled for invasive studies, and Hispanic women (65%) were slightly less willing to take this risk than were white women (75%) (P < .0001). Differences in ethnic background appear to influence women's understanding of mammography, compliance with recall, and preference for early detection of breast cancer.