Abstract C70: Selected Prospective Predictors of Mammography Screening in Hispanic/Latinas Living in the Northeast, US
Authors: Jones Beth A. , Genao Inginia , Nunez-Smith Marcella , Claus Elizabeth , Soler-Vilà Hosanna , Walker Charles , Claye Emma , Markowski Justin H. , Nappi Susan 
Published: March 2017

Background & Objectives:

Hispanic/Latinas (H/Las) are more likely to be diagnosed with later staged breast cancer when compared with White women. Mammography screening, an important early detection tool, is effective when received at regular intervals. National data suggest that mammography screening rates in H/Las are lower than reported for Whites and African Americans. However, little is known about the predictors of screening adherence in the largely immigrant population of Hispanic/Latinas living in the Northeast, US. This is the first report of prospectively measured predictors of non-adherence to mammography screening guidelines in a largely unstudied population, Hispanic/Latinas living in the Northeast, US. As a starting point, we report here on selected core socio-demographic, acculturation, access to care, and medical variables as predictors of mammography screening over 2 to 4 years of follow-up.

Methods:

We conducted hour long telephone interviews with 1600 community-living Hispanic/Latino women, ages 40-75, seeking care at primary care clinics in the 4 cities with the largest Hispanic populations in Connecticut, US. Women with no prior history of breast cancer or biopsy were eligible for inclusion in our study. We collected detailed information on socio-demographic, access to care, medical, health knowledge and belief variables. Screening mammography that occurred during 2-4 years of follow-up was derived from radiology records (n=1570; 98% consented to record review). Bivariate and multivariate predictors (core socio-demographic, access to care, acculturation, and medical variables) of adherence to annual screening guidelines in place at the time of study are reported. Results: Of the 1570 women included in the final cohort, 870 (55.4%) were non-adherent to guidelines calling for annual mammography screening and 610 (38.9%) were non-adherent to guidelines calling for biennial mammography screening. In multivariate analyses that controlled for marital status, education, income, insurance status, continuity of care, selected health factors and acculturation variables, younger (age less than 50), OR = 1.52 (95% CI, 1.22, 1.89) and women who reported fair or poor compared with good or very good self-rated health (OR = 1.30, 95% CI 1.0, 1.62) were non-adherent to guidelines calling for annual screening. In contrast, women with relatively poor English language skills were 30% less likely to be non-adherent (OR 0.70, 95% CI 0.56, 0.96).

Conclusions:

In a study of a large cohort of mostly immigrant Hispanic/Latino women living in the Northeast, US, preliminary results suggest that younger women and those women who report that they are not in good health are at risk for non-adherence to mammography screening guidelines. There is a suggestion that despite a language barrier, some immigrant women may screen more than women who were born in the US. A better understanding of how acculturation factors interact with other patient characteristics is needed.

Citation Format: Beth A. Jones, Inginia Genao, Marcella Nunez-Smith, Elizabeth Claus, Hosanna Soler-Vilà, Charles Walker, Emma Claye, Justin H. Markowski, Susan Nappi. Selected Prospective Predictors of Mammography Screening in Hispanic/Latinas Living in the Northeast, US. [abstract]. In: Proceedings of the Ninth AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2016 Sep 25-28; Fort Lauderdale, FL. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2017;26(2 Suppl):Abstract nr C70.