Abstract B03: Sociodemographic disparities in breast density notification in the 2015 National Health Interview Survey
Authors: Warner Erica T. 
Published: February 2019

Abstract
Purpose: To date, 32 states have passed legislation requiring that the estimated 50% of women with dense breast tissue receive written notification after a mammogram. We investigated whether there are sociodemographic disparities in breast density notification, receipt of supplemental MRI and ultrasound screening, and the association of breast density notification with breast cancer risk perception, using a nationally representative sample from the 2015 National Health Interview Survey.
Methods: Women age 30 or older who reported ever having had a mammogram were asked: “Were you informed that your mammogram showed that you have dense breast tissue?” We present adjusted odds ratios (AOR) and 95% confidence intervals (CI) from logistic regression models accounting for sampling weights for sociodemographic predictors of density notification, supplemental screening, and breast cancer risk perception with adjustment for geographic region, lifestyle, behavioral, and reproductive factors associated with breast density. We further assess the association between density notification and breast cancer risk perception.
Results: Of 10,841 respondents, 2,222 (22.3%) reported receiving notification of dense breast tissue, 8,293 (75.0%) said they had not, and 326 (2.7%) said they did not know. Compared to women with a high school diploma or GED, those with some college (AOR: 1.35, 95% CI: 1.11-1.63) or a college degree or higher (AOR: 1.79, 95% CI: 1.49-2.16) were significantly more likely to report density notification. Non-Hispanic (NH) Black (AOR: 0.55, 95% CI: 0.44-0.70), Hispanic (AOR: 0.53, 95% CI: 0.39-0.73), and NH-Asian (AOR: 0.49, 95% CI: 0.37-0.66) women were less likely than NH-White women to report being notified. Women whose last mammogram was five or more years prior to survey were 36% less likely (AOR: 0.64, 95% CI: 0.45-0.91) to report notification than those with a mammogram in the past two years. Notified women were more likely to have MRI or ultrasound follow-up tests after their most recent mammogram. Women who reported breast density notification were 72% more likely (AOR: 1.72, 95% CI: 1.42-2.07) to report they had higher risk of breast cancer than an average woman their age. Compared to NH-Whites, NH-Black women were less likely to assess themselves as at higher risk, and race did not modify the association between notification and breast cancer risk perception.
Conclusions: The purpose of breast density notification is to empower women to make informed decisions about breast-cancer screening, including supplemental use of MRI and ultrasound. Higher reports of density notification among NH-Whites and women with higher educational attainment may reflect greater understanding of notification materials. Additional interventions may be required among lower-education and minority populations to ensure that the purpose of density notification is met.
Citation Format: Erica T. Warner. Sociodemographic disparities in breast density notification in the 2015 National Health Interview Survey [abstract]. In: Proceedings of the Tenth AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2017 Sep 25-28; Atlanta, GA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2018;27(7 Suppl):Abstract nr B03.