Psychological Factors Explain Some of Mammogram Gap

Studies have shown that black women are less likely than white women to get mammograms, but focusing on race alone may be a mistake, results of a new study suggest.

In fact, attitudes and emotions of individual women may go a long way toward explaining racial differences in mammogram use, researchers report. The lower rate of mammogram use among minority women has mostly been attributed to lower levels of education and income. But more and more studies have found that psychological and emotional factors may play a role in women’s decisions about mammograms. For instance, research suggests that women who believe that cancer treatments are not effective are less likely to have a mammogram. Most studies that have looked at the relationship between women’s attitudes and mammogram use have included predominantly white women, however. To close this gap, a team led by Dr. Carol Magai of Long Island University’s Brooklyn Campus in New York interviewed a multiethnic group of more than 1,300 women between 50 and 70 years old. Based on interviews with the women, the researchers determined that African-American and Dominican women who had been born in the U.S. had mammograms as frequently as European-American women. But other groups of women, including women from Haiti, Eastern Europe and English-speaking parts of the Caribbean, were 55 percent to 74 percent less likely to have regular mammograms. Several non-racial factors may explain these differences, according to the researchers. For instance, women who believed that bruises or sores can cause cancer were less likely to have regular mammograms. On the other hand, women who believed that surgery can be effective if cancer is detected early were more likely to get regular mammograms. When the researchers took into account women’s attitudes and emotional and social factors, women from Haiti or other parts of the Caribbean were no longer less likely to get mammograms. And taking account these factors also narrowed the mammogram gap in Eastern European women.Magai and her colleagues note that variance in mammogram use may be explained at least in part by some of these attitudes. To improve mammogram rates, it is important not to lump together all women of the same racial or ethnic group, according to Magai. “For example, there are various sub-groups of black women, including U.S.-born African-Americans, Jamaicans, Haitians, Trinidadians, Nigerians, South Africans,” Magai told Reuters Health. “To assume that they all share identical social histories and cultural values, beliefs and attitudes would be a mistake, yet much medical research is not yet aware or tuned in to this kind of intercultural variation,” she said. To encourage more women to get mammograms, “we must understand and address the particular groups we want to reach in their own cultural language,” Magai said. The results of the study were published Monday in the online version of the journal Cancer and will appear in the journal’s June 1 issue. (Source: Cancer, June 1, 2004: Reuters Health News: April 2004)