Mammography Results Poorly Communicated to Blacks

NEW YORK FEB 22, 2007 (Reuters Health) - African American women are less likely than whites to receive adequate communication of their mammography results, a new study conducted in Connecticut shows.

When a black woman"s results were abnormal, they were more likely to be poorly communicated to her than when the results were normal. But the reverse was true for whites.

"This statistically significant interaction suggests that the "real world" efficacy of mammography screening is somewhat compromised for African American women," Dr. Beth A. Jones and colleagues from the Yale University School of Medicine in New Haven, write.

Compared with whites, African American women are more likely to die from breast cancer and are diagnosed at a significantly later stage of the disease, Jones and her team note in the American Journal of Public Health. They therefore looked at the possible effect of racial differences on communication of mammography results, which might help account for this disparity.

The researchers surveyed 411 black women and 734 whites who underwent mammographies at five different hospital-based centers. Overall, 14.5 percent of the women reported problems with communication of the results; 12.5 percent reported that they didn"t receive the results and 2 percent said the results that were reported were different from those on their medical records. Among the 23 women who misunderstood their results, 18 thought their results were normal, although their records showed that the results were abnormal.

Black women were twice as likely to experience poor communication of mammography results, with 20.9 percent falling into this group compared with 10.9 percent of whites.

And 31.3 percent of abnormal mammography results were inadequately communicated to black women, compared with 19 percent of normal results. For whites, 6.5 percent of abnormal results were communicated inadequately, compared with 11.5 percent of normal results, not a statistically significant difference.

The study was done before the Mammography Quality Standards Reauthorization Act of 1998, which requires mammography facilities to give women results of the breast cancer screening test written in lay terms, went into effect, the authors note.

Nevertheless, the new law doesn"t address possible communication breakdown points; for example, letters were reported as never being received or being sent to the wrong address.

Fixing these communication disparities may help remedy racial differences in breast cancer outcomes, Jones"s team add.

"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," they conclude.

SOURCE:

• American Journal of Public Health, 2007.