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    Research Grants Awarded

    Access to Mammography Facilities and Use of Screening Mammography by African American Women

    Study Section:
    Population Specific

    Scientific Abstract:
    Background: Racial disparities in breast cancer outcomes have been linked to disparities in the use of screening mammography. African American women are generally less likely than white women to receive screening mammography consistent with consensus recommendations. Objective: The goal of this research is to assess the extent to which the availability of mammography resources explains screening utilization patterns in African American women. Specific Aims: 1) To characterize the distribution of mammography facilities relative to the proportion of African American residents in all US counties; 2) To describe access-related characteristics of mammography facilities in counties with a high proportion of African American women; 3) To assess the extent to which variation in the availability and characteristics of mammography facilities explains racial disparities in screening. Study Design: We will use data from the US Food and Drug Administration (FDA) to identify all certified mammography facilities and the number of machines, technologists and radiologists at each facility. In Aim 1, we will combine the mammography facility data with US Census data to evaluate the distribution of mammography resources in relation to the African American population in each county. In Aim 2, we will collect information on facility hours, mammography volume, appointment waiting times, and health insurance restrictions by telephone and mail surveys of mammography facilities in counties with large African American populations. In Aim 3, we will use national survey data and Medicare claims, combined with the FDA data and facility survey data, to assess how the availability and characteristics of mammography facilities affect screening rates in African American women. Potential Outcomes: This research will identify areas and predictors of undersupply, oversupply, and maldistribution of mammography resources, and the extent to which the distribution of these resources explains the lower use of screening by African American women. The facility survey will provide insight regarding the role of facility access barriers in areas with large African American populations. This information will indicate whether changes in the supply, location and characteristics of mammography facilities may increase screening rates in African American women and suggest how resources can be deployed most effectively to reduce racial disparities in breast cancer screening and outcomes.

    Lay Abstract:
    Compared with white women, African American women with breast cancer are more likely to be diagnosed at an advanced stage and they are more likely to die of their disease. This racial disparity in breast cancer outcomes has been linked, in part, to lower use of screening mammograms by African American women. The goal of this research is to assess whether lower rates of screening mammography in African American women can be explained by a lack of mammography resources in areas with large African American populations. Specific Aim1 is to describe the number and location of mammography facilities relative to the African American population in all US counties. We will use data from the US Food and Drug Administration (FDA) to identify all certified mammography facilities and the number of machines, technologists and radiologists at each facility. We will combine these data with US Census data to evaluate the distribution of mammography resources relative to the African American population in each county. Specific Aim 2 is to describe characteristics of mammography facilities in areas with large African American populations. This will be accomplished by telephone and mail surveys of mammography facilities in counties with a high proportion of African American residents. We will collect information on facility hours, mammography volume, appointment waiting times, and health insurance restrictions. Specific Aim 3 is to assess how variation in the availability and characteristics of mammography facilities is related to the use of screening by African American women. We will use national survey data and Medicare claims, combined with the FDA data and facility survey data, to examine how the availability and characteristics of mammography facilities influence screening rates in African American women. This research will identify areas with limited mammography availability and the extent to which lack of availability explains the lower use of screening by African American women. The facility survey will help us understand the role of facility access barriers in areas with large African American populations. This information will indicate whether changes in the supply, location and characteristics of mammography facilities may increase screening rates in African American women and suggest how resources can be used most effectively to reduce racial disparities in breast cancer screening and outcomes.