Download or read book Racial Disparities in Mammography Utilization in Women Under 40 written by Rachel Marie Dolan and published by . This book was released on 2010 with total page 45 pages. Available in PDF, EPUB and Kindle. Book excerpt: Breast cancer is the most common cancer in women. Although black women have a lower incidence of breast cancer compared to white women, their overall mortality is higher. Black women are more likely to get cancer at a younger age and at a more advanced stage. Mammography is the best form of secondary prevention for breast cancer; however, previous research indicates that black women over 40 are less likely to receive a mammogram than white women. Mammography utilization in women under 40 has had little evaluation. Employing a logistic regression analysis to the 2006 Medical Expenditure Panel Survey Household Component, this study attempts to determine if racial disparities do exist in mammography utilization, as this could indicate a need for a change in policy with regards to screening for breast cancer. This analysis finds that race is associated with mammography utilization. The results indicate that controlling for income, education, age and insurance status, black women age 30 to 39 are on average more likely to have ever had a mammogram than white women in this age group. Demographic and personal characteristics also differ in importance across different racial and ethnic groups. Future research should focus on women with increased risk factors such as a family history of breast cancer or a genetic predisposition to determine if screening differs by race among women of different risks. When considering future policies, it is important to enable women to know their personal risk, as well as ensure that high-risk women of any age continue to be able to access preventive screening.
Download or read book Understanding Racial Disparities in Mammography Use Among Breast Cancer Survivors written by and published by . This book was released on 2002 with total page 32 pages. Available in PDF, EPUB and Kindle. Book excerpt: Despite general consensus that breast cancer (BC) survivors should undergo annual mammography, findings indicate over 1 in 7 women fail to receive a mammogram within 2 years of BC treatment, and that African Americans are almost half as likely to participate in mammography screening as Caucasians. To develop and pilot test a survey instrument to understand what factors influence a BC survivor's decision to receive mammography and whether differences exist in these factors by patient race. Methods: Using information from the literature and focus groups (two each among African American and Caucasian BC survivors), we developed a mailed patient survey, which was mailed to African American and Caucasian BC survivors. Results were analyzed to identify the beliefs, social influences, and preferences for mammography screening attributes. Results: Overall, general trends showed that test accuracy, friendliness of staff, and ease of appointment scheduling were important attributes to mammogram screening use. Although the low response rates among non-users precluded us from comprehensively evaluating racial differences in the factors associated with mammogram use following BC treatment, the results provide promising preliminary data. Future research will continue investigations into understanding the mammography use decision making process and how this process differs by race. A primary consideration will also be how to improve research participation rates among non-users.
Download or read book Health Disparities with Mammogram and Pap Test Utilization Among Low Income African American Women written by Aarathi Kallur and published by . This book was released on 2023 with total page 0 pages. Available in PDF, EPUB and Kindle. Book excerpt: Black women and other minority women have high mortality rates from breast cancer and cervical cancer. Mortality from both of these cancers are highly preventable through routine mammograms, which are x-rays of breast tissue, and Pap smear tests, which study the cells in the cervix. Both of these tests can detect cancerous cells before the cancer progresses to later stages, and detecting cancer early can give a patient the best chance for survival. If cancer is caught in the later stages, then there is a lower chance for survival and higher treatment costs (World Health Organization, 2023). A systemic literature review and quantitative analysis was done to understand the various factors that affect the utilization of these preventative tests. The purpose of this study is to analyze the utilization rates of mammograms and Pap smear tests among low-income Black women and other minority women. The study also aims to identify some of the factors that are associated with utilization rates such as education, income, and insurance status. The Medical Expenditure Panel Survey (MEPS) data from 2018 was used to observe the different rates of utilization among white, African American, Asian, Indigenous, Hispanic, and mixed-race women of various age groups. The utilization was also broken down into race and then further into education level, income level, and insurance status. A linear regression analysis was done to look at the correlation between race and insurance status, education, and income. The results showed that mammogram utilization among Black women 40 years old and older was 42.37%. Mammogram utilization was lower for those in poor, near-poor, and low-income categories, whereas Black women aged 65 and older those with Medicare and private insurance had the highest utilization. Pap smear utilization among Black women from ages 21 to 64 was 49.45%. The near-poor category had the lowest utilization of Pap smears. The results indicate that income and insurance status have a significant impact on the utilization of these preventative tests among minority women. However, further research must be done to better understand the policy implications of these barriers in order to increase utilization.
Download or read book Examining Factors Associated with Utilization of Mammography Screening for Women of Age 40 74 Years in Washington State written by Abhishek Savant and published by . This book was released on 2009 with total page 75 pages. Available in PDF, EPUB and Kindle. Book excerpt:
Download or read book The Utilization of Mammography and Cervical Cancer Screening by Mexican American and Yaqui Indian Women written by Margaret A. Hoeft and published by . This book was released on 1993 with total page 248 pages. Available in PDF, EPUB and Kindle. Book excerpt:
Download or read book Understanding Poor and Minority Women who are Unscreened Or Underscreened for Breast Cancer written by Kassandra I. Alcaraz and published by . This book was released on 2012 with total page 135 pages. Available in PDF, EPUB and Kindle. Book excerpt: Despite progress in increasing breast cancer screening rates for more than two decades, disparities in screening mammography persist. Women who are unscreened (i.e., never had a mammogram) or underscreened (i.e., last mammogram was more than two years ago) are disproportionately poor and from racial/ethnic minority groups. Targeted interventions are badly needed as behavioral interventions promoting use of mammography have not been particularly effective among unscreened and underscreened women. Little is known about the broader context of these women's lives, yet this information seems particularly promising for identifying the intervention needs and capacities of these populations. Using a sample of predominantly poor and racial/ethnic minority women who are age-eligible for mammography, the study aims to (1) identify distinct subgroups of women based on patterns of variation in demographic and health-related characteristics associated with screening behavior and (2) identify contextual factors associated with screening behavior by examining the extent to which contextual variables distinguish membership in the identified subgroups. As part of a larger ongoing randomized intervention trial, callers to United Way 2-1-1 Missouri complete a cancer risk assessment and baseline survey at the end of their standard 2-1-1 call. Over a 20-month period during 2010-2012, 711 female callers ages 40 and older answered questions related to use of mammography, other health behaviors, provider recommendation for mammography, social norms for mammography, health insurance coverage, self-rated general health, and individual contextual issues (social capital, perceived stress, unmet basic needs, sense of coherence, and children living in the home). Data from the 2010 U.S. Census assessed area-level characteristics of participants' residential areas. Data were analyzed using Chi-squared Automatic Interaction Detection (CHAID) and multinomial logistic regression. The study found six distinct subgroups with varying patterns of screening (p
Download or read book Trends and Racial Disparities in Breast Cancer Screening written by Smruti Jadav and published by . This book was released on 2013 with total page pages. Available in PDF, EPUB and Kindle. Book excerpt: Objective: (i) To describe the national trend of mammogram screening, clinical breast examination and breast cancer screening from 2000 to 2010 by race. (ii) To estimate racial disparities for mammogram screening, clinical breast examination and breast cancer screening from 2000 to 2010. Methods: Medical Expenditure Panel Survey (MEPS) data from 2000 to 2010 was used for the analysis. All females with age ≥40 years were included in the study. Outcome variables were mammogram screening (MS), clinical breast examination (CBE) and breast cancer screening (BCS). MS and CBE were defined as those females who received MS and CBE respectively in previous one or two years. BCS was defined as those who received MS and CBE (both) in previous one or two years. Main independent variable was race categorized as non-Hispanic whites (NHW), non-Hispanic blacks (NHB), Hispanics and others. Descriptive analysis was conducted to describe the national trends in MS, CBE and BCS for each year from 2000 to 2010 by race. Bivariate and multivariate logistic regression was conducted to identify racial disparities in MS, CBE and BCS; and non-linear Blinder Oaxaca decomposition was conducted to decompose disparities in explained and unexplained component. Results: Final cohort consisted of 79,068 females (weighted sample size= 764,361,258). MS, CBE and BCS rates were almost stable throughout the decade. In multivariate logistic regression, NHB (OR: 1.27, 95% CI: 1.16-1.40, p
Download or read book Health United States 2016 with Chartbook on Long Term Trends in Health written by National Center for Health Statistics and published by Government Printing Office. This book was released on 2017-08-16 with total page 494 pages. Available in PDF, EPUB and Kindle. Book excerpt: This annual overview report of national trends in health statistics contains a Chartbook that assesses the nation's health by presenting trends and current information on selected measures of morbidity, mortality, health care utilization and access, health risk factors, prevention, health insurance, and personal health-care expenditures. Chapters devoted to population characteristics, prevention, health risk factors, health care resources, personal health care expenditures, health insurance, and trend tables may provide the health/medical statistician, data analyst, biostatistician with additional information to complete experimental studies or provide necessary research for pharmaceutical companies to gain data for modeling and sampling. Undergraduate students engaged in applied mathematics or statistical compilations to graduate students completing biostatistics degree programs to include statistical inference principles, probability, sampling methods and data analysis as well as specialized medical statistics courses relating to epidemiology and other health topics may be interested in this volume. Related products: Your Guide to Choosing a Nursing Home or Other Long-Term Services & Supports available here: https://bookstore.gpo.gov/products/your-guide-choosing-nursing-home-or-other-long-term-services-supports Health Insurance Coverage in the United States, 2014 available here: https://bookstore.gpo.gov/products/health-insurance-coverage-united-states-2014 "Some System of the Nature Here Proposed": Joseph Lovell's Remarks on the Sick Report, Northern Department, U.S. Army, 1817, and the Rise of the Modern US Army Medical Department can be found here: https://bookstore.gpo.gov/products/some-system-nature-here-proposed-joseph-lovells-remarks-sick-report-northern-department-us Guide to Clinical Preventive Services 2014: Recommendations of the U.S. Preventive Services Task Force (ePub) -Free digital eBook download available at the US Government Online Bookstore here: https://bookstore.gpo.gov/products/guide-clinical-preventive-services-2014-recommendations-us-preventive-services-task-force --Also available for FREE digital eBook download from Apple iBookstore, BarnesandNoble.com (Nook Bookstore), Google Play eBookstore, and Overdrive -Please use ISBN: 9780160926426 to search these commercial platforms.
Download or read book Unequal Treatment written by Institute of Medicine and published by National Academies Press. This book was released on 2009-02-06 with total page 781 pages. Available in PDF, EPUB and Kindle. Book excerpt: Racial and ethnic disparities in health care are known to reflect access to care and other issues that arise from differing socioeconomic conditions. There is, however, increasing evidence that even after such differences are accounted for, race and ethnicity remain significant predictors of the quality of health care received. In Unequal Treatment, a panel of experts documents this evidence and explores how persons of color experience the health care environment. The book examines how disparities in treatment may arise in health care systems and looks at aspects of the clinical encounter that may contribute to such disparities. Patients' and providers' attitudes, expectations, and behavior are analyzed. How to intervene? Unequal Treatment offers recommendations for improvements in medical care financing, allocation of care, availability of language translation, community-based care, and other arenas. The committee highlights the potential of cross-cultural education to improve provider-patient communication and offers a detailed look at how to integrate cross-cultural learning within the health professions. The book concludes with recommendations for data collection and research initiatives. Unequal Treatment will be vitally important to health care policymakers, administrators, providers, educators, and students as well as advocates for people of color.
Download or read book Disparities in Mammography Utilization Patterns According to Geographic Access and Car Ownership and Long Term Mammography Utilization Among Ductal Carcinoma in Situ Survivors written by Patricia Isabelle Jewett and published by . This book was released on 2017 with total page 0 pages. Available in PDF, EPUB and Kindle. Book excerpt: Background: In the vehicle-centered US transportation system, limited geographic and transportation access can reinforce existing social disparities in health care utilization. One objective of this work was to identify subpopulations which are likely not to own a car, and to assess the associations of car ownership and geographic access with mammography and general preventive care utilization. The second objective was to describe long-term mammography utilization among ductal carcinoma in situ (DCIS) survivors, applying a novel regression methodology that incorporated distribution assumptions on aggregated mammogram counts. Methods: Data for this work came from the 2014-15 Survey of the Health of Wisconsin, and the 1997-2007 Wisconsin Women's Health and Wisconsin In Situ Cohort Studies. We used logistic and proportional odds regression to model the odds of car ownership, and of more frequent mammography and general care utilization, with the main predictors: driving times to, and number of, mammography facilities near women's homes, and car ownership. We used Poisson regression to estimate long-term mammography utilization among DCIS survivors, with the main predictors: treatment, age at diagnosis, and family history of breast cancer. We used data visualizations to test hypotheses that we could not evaluate statistically. Results: Young and old age, low incomes, and racial/ethnic minority status were associated with decreased odds of car ownership. Having at least one nearby mammography facility was associated with greater mammography frequency, but effects of driving times and car ownership on health care utilization were inconsistent or non-significant. Among DCIS survivors, we detected a statistically but not clinically significant decline in mammography rates with time. Younger age and treatment with lumpectomy/radiation were associated with more frequent imaging surveillance, but without clinically meaningful effects. Conclusion: Geographic and transportation access may not be strong utilization predictors for the health care services we assessed, especially in the general population. Future research should focus on low income groups and racial/ethnic minorities and their access to daily life activities. Future research should also confirm that DCIS survivors are stable long-term mammography users as indicated by our findings. Our modeling approach that incorporated distribution assumption on aggregated data may have applications in other fields.
Download or read book Breast Cancer Metastasis and Drug Resistance written by Aamir Ahmad and published by Springer Nature. This book was released on 2019-08-27 with total page 427 pages. Available in PDF, EPUB and Kindle. Book excerpt: Resistance to therapies, both targeted and systemic, and metastases to distant organs are the underlying causes of breast cancer-associated mortality. The second edition of Breast Cancer Metastasis and Drug Resistance brings together some of the leading experts to comprehensively understand breast cancer: the factors that make it lethal, and current research and clinical progress. This volume covers the following core topics: basic understanding of breast cancer (statistics, epidemiology, racial disparity and heterogeneity), metastasis and drug resistance (bone metastasis, trastuzumab resistance, tamoxifen resistance and novel therapeutic targets, including non-coding RNAs, inflammatory cytokines, cancer stem cells, ubiquitin ligases, tumor microenvironment and signaling pathways such as TRAIL, JAK-STAT and mTOR) and recent developments in the field (epigenetic regulation, microRNAs-mediated regulation, novel therapies and the clinically relevant 3D models). Experts also discuss the advances in laboratory research along with their translational and clinical implications with an overarching goal to improve the diagnosis and prognosis, particularly that of breast cancer patients with advanced disease.
Download or read book Racial ethnic Disparities in Annual Mammogram Compliance Among Households in Little Haiti Miami Dade County Florida written by and published by . This book was released on 2016 with total page pages. Available in PDF, EPUB and Kindle. Book excerpt: Abstract: Introduction: Breast cancer is the most commonly diagnosed cancer and the 2nd leading cause of cancer-related deaths among women in the U.S. Although routine screening via mammogram has been shown to increase survival through early detection and treatment of breast cancer, only 3 out of 5 women age ≥40 are compliant with annual mammogram within the U.S. and the state of Florida. A breadth of literature exists on racial/ethnic disparities in compliance with mammogram; however, few such studies include data on individual Black subgroups, such as Haitians. This study assessed the association between race/ethnicity and annual mammogram compliance among randomly selected households residing in the largely Haitian community of Little Haiti, Miami-Dade County (MDC), Florida. Methods: This study used cross-sectional, health data from a random-sample, population-based survey conducted within households residing in Little Haiti between November 2011 and December 2012 (n = 951). Mammogram compliance was defined as completion of mammogram by all female household members within the 12 months prior to the survey. The association between mammogram compliance and race/ethnicity was assessed using binary logistic regression models. Potential confounders were identified as factors that were conservatively associated with both compliance and race/ethnicity ( P ≤ 0.20). Analyses were restricted to households containing at least 1 female member age ≥40 (n = 697). Results: Overall compliance with annual mammogram was 62%. Race/ethnicity was significantly associated with mammogram compliance ( P = 0.030). Compliance was highest among non-Hispanic Black (NHB) households (75%), followed by Hispanic (62%), Haitian (59%), and non-Hispanic White (NHW) households (51%). After controlling for educational level, marital status, employment status, the presence of young children within the household, health insurance status, and regular doctor visits, a borderline significant disparity in mammogram compliance was observed between Haitian and NHB households (adjusted odds ratio = 1.63, P = 0.11). No other racial/ethnic disparities were observed. Discussion: Compliance with annual mammogram was low among the surveyed households in Little Haiti. Haitian households underutilized screening by means of annual mammogram compared with NHB households, although this disparity was not significant. Compliance rates could be enhanced by conducting individualized, mammogram screening-based studies to identify the reasons behind low rate of compliance among households in this underserved, minority population.
Download or read book Applying Advanced Methods to Population based Survey Data for Purposes of Breast Cancer Control written by Karen L. Schneider and published by . This book was released on 2008 with total page 198 pages. Available in PDF, EPUB and Kindle. Book excerpt: Often, methods used to analyze national health survey data on cancer screening have been descriptive in nature, reporting prevalence estimates and bivariate results from chi-square tests. Some studies have identified correlates of screening using individual-level logistic regression models. However, the richness of the data and the large sample sizes allow for more complex analyses to evaluate the influence of both individual-level and community-level variables on mammography utilization. Thus, the purpose of this dissertation was to demonstrate the utility of two different advanced methods not normally used to analyze national health survey data in the context of mammography: small-area estimation and multilevel modeling. We used Behavioral Risk Factor Surveillance System (BRFSS) data, linked with U.S. Census and Area Resource File data. Also, we attempted to explore how data quality (i.e. non-response bias) impacts the validity of prevalence estimates obtained from the BRFSS. We evaluated sociodemographic factors often related to mammography, such as income, marital status, and race/ethnicity. First, we found that small area estimation was advantageous for surveillance of mammography utilization on the county-level. This method allowed documentation of geographic disparities and improved our understanding of the spatial distribution of mammography prevalence. We concluded that researchers should consider such county-level variation in future analyses and intervention design. Second, a multilevel model that included county-level contextual confounders only negligibly impacted the association between individual-level race/ethnicity and mammography. However, stratifying individual-level analyses by county-level poverty rate showed that context does influence Hispanic women's receipt of mammography Future policies that equalize health care access across racial/ethnic groups and target resources to Hispanics living in high poverty may improve screening prevalence for all groups and eliminate disparities. Finally, we found that BRFSS prevalence estimates diverged from Census estimates on several sociodemographic factors, even after adjustment for non-response---more so when estimating county-level prevalence. Lower response rates (
Download or read book A Comparison of Breast Cancer Treatment Regimens by Demographic Characteristics written by and published by . This book was released on 1999 with total page 18 pages. Available in PDF, EPUB and Kindle. Book excerpt: The purpose of this study was to measure ethnic differences in treatment and survival between African American (AA) and European American (EA) women with breast cancer. We abstracted data on cases of breast cancer diagnosed in members of an HMO in metropolitan Detroit between 1986-1996 (N=886) and followed these cases for survival through April 1997 (N=137 deaths). AA women were diagnosed at a later stage when compared with EA women. Five-year survival was 77% for AAs and 84% for EAs. The crude hazard for AAs relative to EAs was 1.6 (95% confidence interval (CI) 1.1, 2.2). Adjusting only for stage of disc at diagnosis, the hazard ratio was 1.3 (95% CI 0.9, 1.9). Adjusting only for sociodemographics (age, marital status an income), the hazard ratio was 1.2 (95% CI 0.8, 1.9). After adjusting for sociodemographics and stage, the hazard ratio 1.0 (95% CI 0.7, 1.5). We found no material racial differences in the surgical management of breast cancer. Among women with similar medical care access, we found ethnic differences in stage of breast cancer at diagnosis. Adjusting this difference and for income, age and marital status, eliminates the effect of race on survival. The methods used in this study as well as the cohort of women that was assembled for this study has also lead additional analyses contributing to the development of hypotheses that will be investigated in future studies. Preliminary results of one analysis examining ethnicity, stage of detection and mammography use show that among women age 40-49 AA ethnicity was strongly associated with later stage at diagnosis, even after adjustment for screening mammography (adjusted odds ratio= 2.8, 95% CI 1.2-6.8). These results indicate that factors other than mammography use may explain late stage at diagnosis in the subgroup of younger (age 40-49) African American women.
Download or read book Analysis of Breast Cancer Screening Policies Using Partially Observable Markov Decision Processes written by Mucahit Cevik and published by . This book was released on 2016 with total page 0 pages. Available in PDF, EPUB and Kindle. Book excerpt: In this dissertation, we study three aspects of the breast cancer screening problem: impact of breast density and supplemental screenings, screening in resource-restricted settings and racial disparities in breast cancer outcomes. We first analyze the impacts of breast density and supplemental tests on breast cancer screening policies. We formulate the breast cancer screening problem using a discrete-time partially observable Markov decision process (POMDP) model. The state space of our model is composed of the patient's health states and the breast density states. At each decision epoch, the physician first decides whether or not the patient should undergo mammography screening, and then uses mammography result to decide whether or not to follow up with supplemental screening. Our numerical study demonstrates that incremental benefit of supplemental tests over digital mammography is rather limited; in particular, patients with high breast cancer risk should be recommended more frequent mammography screenings instead of supplemental tests. Next, we investigate the optimal allocation of limited mammography resources to screen a population. We propose a constrained POMDP model that maximizes total expected quality-adjusted life years of the patients when they are allowed only a limited number of mammography screenings. We use a variable resolution grid-based approximation scheme to convert the constrained POMDP model into a mixed-integer linear program and conduct several numerical experiments using breast cancer epidemiology data. We observe that as mammography screening capacity decreases, patients in the 40-49 age group should be given the least priority with respect to screening. We further find that efficient allocation of available resources between patients with different risk levels leads to significant quality-adjusted life year gains, especially for the patients with higher breast cancer risk. Finally, we consider race as a risk factor for breast cancer and investigate the contributing factors leading to higher breast cancer mortality among black women. We modify the University of Wisconsin Breast Cancer Simulation model to obtain race-specific models and analyze the differences in disease natural history, treatment utilization and mammography uptake. Our findings indicate that targeted prevention and detection strategies that go beyond equalizing access to mammography may be needed to eliminate racial disparities.
Download or read book Enabling Characteristics of Mammography Facilities written by Mythreyi Bhargavan and published by . This book was released on 2007 with total page 0 pages. Available in PDF, EPUB and Kindle. Book excerpt: Rationale: Women in locations with large minority populations are less likely to have a periodic screening mammogram than women in affluent high-white locations. While proximity to facilities may explain some of the differences in utilization, little is know about whether facilities in high-minority locations are less likely to have "enabling characteristics" that facilitate access and use of services by their clientele. Enabling characteristics of care providers are a major component of the standard conceptual framework used to study access to care. However, they have received remarkably little empirical study although the literature on access is large. Objectives: To examine if mammography facilities that locate in minority areas have less convenient hours, do less to assure that patients return, and perform less outreach in the community. Methodology: We will conduct a telephone survey of mammography facilities. The facilities to survey will be sampled from the FDA/ACR complete listing of mammography facilities. Office managers are the target respondents; when they cannot be reached, the survey will be addressed to front office staff who make appointments. The survey will collect data on facility characteristics that promote or ease use of the facility, such as whether the facility is open extended hours, accepts charity patients, performs outreach in the community, and has non-English speaking staff. In addition, the survey will collect data on general facility characteristics, such as whether the facility is academic or not and number of patients seen per week. Data from the U.S. census will be used to measure the racial/ethnic composition and demographic and socioeconomic characteristics of the location of the facility. Results: A pilot survey was conducted on 105 facilities. Descriptive statistics indicate that facilities in heavily-minority zip codes have, if anything, slightly more numerous enabling characteristics. In particular, they are far more likely to have non-white staff and staff members who speak languages other than English. Also, they are somewhat more likely to accept charity patients (in heavily black and heavily Asian zip codes), and use posters and flyers for outreach (in heavily black and heavily Hispanic zip codes). Evening and weekend hours are sparse in all settings. Almost no facilities make next year's appointment when the patient is present for this year's mammogram. Very few facilities carry on outreach to primary care physicians. Only half or fewer of facilities in heavily minority zip codes participate in a CDC program that provides free mammograms for poor women. Conclusion: Preliminary results indicate that mammography facilities serving minority areas are no less committed to patient care than facilities in high-white neighborhoods. Our larger-scale survey will show whether the pilot study's findings are borne out in a multivariable model that, because of larger sample size, can include many neighborhood socioeconomic and demographic controls. If so, it will ascertain in just what ways facilities in heavily minority neighborhoods do more to enable access than those in predominantly white neighborhoods.
