Does utilization of screening mammography explain racial and ethnic differences in XXXX ?

@entity5 @entity1 @entity0
BACKGROUND: Reasons for persistent differences in @entity0 mortality rates among various racial and ethnic groups have been difficult to ascertain. OBJECTIVE: To determine reasons for disparities in @entity0 outcomes across racial and ethnic groups. DESIGN: Prospective cohort. SETTING: The authors pooled data from 7 mammography registries that participate in the National @entity5 Institute-funded @entity0 Surveillance Consortium. @entity5 diagnoses were ascertained through linkage with pathology databases; Surveillance, Epidemiology, and End Results programs; and state @entity5 registries. @entity1 : 1,010,515 @entity1 40 years of age and older who had at least 1 mammogram between 1996 and 2002; 17,558 of these @entity1 had diagnosed @entity0 . MEASUREMENTS: Patterns of mammography and the probability of inadequate mammography screening were examined. The authors evaluated whether overall and advanced @entity5 rates were similar across racial and ethnic groups and whether these rates were affected by the use of mammography. RESULTS: African-American, Hispanic, Asian, and Native American @entity1 were more likely than white @entity1 to have received inadequate mammographic screening (relative risk, 1.2 [95% CI, 1.2 to 1.2], 1.3 [CI, 1.2 to 1.3], 1.4 [CI, 1.3 to 1.4], and 1.2 [CI, 1.1 to 1.2] respectively). African-American @entity1 were more likely than white, Asian, and Native American @entity1 to have large, advanced-stage, high-grade, and lymph node-positive @entity5 of the breast. The observed differences in advanced @entity5 rates between African American and white @entity1 were attenuated or eliminated after the cohort was stratified by screening history. Among @entity1 who were previously screened at intervals of 4 to 41 months, African-American @entity1 were no more likely to have large, advanced-stage @entity5 or lymph node involvement than white @entity1 with the same screening history. African-American @entity1 had higher rates of high-grade @entity5 than white @entity1 regardless of screening history. The lower rates of advanced @entity5 among Asian and Native American @entity1 persisted when the cohort was stratified by mammography history. LIMITATIONS: Results are based on a cohort of @entity1 who had received mammographic evaluations. CONCLUSIONS: African-American @entity1 are less likely to receive adequate mammographic screening than white @entity1 , which may explain the higher prevalence of advanced @entity0 among African-American @entity1 . Tumor characteristics may also contribute to differences in @entity5 outcomes because African-American @entity1 have higher-grade @entity5 than white @entity1 regardless of screening. These results suggest that adherence to recommended mammography screening intervals may reduce @entity0 mortality rates.
