Mammography Compliance for Arizona and New Mexico Hispanic and American Indian Women, 2016-2018

Abstract

IntroductionHispanics and American Indians (AI) experience lower breast cancer incidence than non-Hispanic White (NHW) women but experience later-stage diagnoses and lower survival rates. Findings suggest that more screening is needed to enhance early detection. This research aims to describe current breast cancer screening utilization for Hispanic and AI women living in the Southwestern United States. Aim 1 examines mammography compliance for these women by age and race/ethnic group. Aim 2 identifies factors associated with compliance for women between 50-74 years. MethodsSample-weighted 2016 and 2018 Behavioral Risk Factor Surveillance System (BRFSS) for Arizona and New Mexico was used to assess the United States Preventative Services Task Force (USPSTF) compliance for breast cancer screening and compared to other national compliance recommendations. Unadjusted and adjusted logistic regressions were used to calculate odds ratios (OR) and 95% confidence intervals (CI) to evaluate associations between mammography compliance and covariates by racial and ethnic group. Analyses were restricted to women 40 years and older and included only Hispanic, AI, and NHW women (n=12,830). Covariates were checked for collinearity. Potential confounding was evaluated utilizing the 10% change rule. ResultsNHW women reported the highest frequency of ever having a mammogram (93.5%) compared to Hispanic (85.7%) and AI (83.6%) women. Overall, 75.1% of Hispanic women 50-74 years of age reported a mammogram in the past two years (USPSTF compliant) compared to 73.9% of NHW and 71.0% of AI women. For women aged 40-49, 57.2% of NHW women reported mammograms in the past two years, compared to 54.5% of Hispanic and 45.3% of AI women. As for women greater than 75 years of age, 63.0% of Hispanic women 50-74 years of age reported a mammogram in the past two years compared to 60.4% of NHW and 55.5% of AI women. Among women 50-74 years of age, Hispanic, AI and NHW who reported having visited a doctor in the past 12 months had greater odds of being USPSTF mammography compliant than those who were not (OR=4.2, CI 2.4-7.2, OR=2.9, CI 1.4-5.6 and OR=3.2, CI 2.5-4.1, respectively). The same was seen for AI and NHW women who reported having current medical insurance (AI OR= 9.6, CI 3.7-25.0 and NHW OR=1.9, CI 1.1-3.9). A sensitivity analysis conducted by state returned consistent results for current medical insurance and visiting a health care provider in the past 12 months. State differences were not statistically significant. ConclusionOverall, 74% of women ages 50-74 were USPSTF compliant. Having visited a health care provider in the past 12 months was essential for compliance for all included racial/ethnic groups. However, AI and NHW women had statistically significant differences for ‘having a personal doctor,’ suggesting unique challenges faced by racial/ethnic groups when deciding to receive a mammogram.