Fewer Mammograms May Boost Black Women's Breast Cancer Risk

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Although black and Hispanic women had more severe breast cancer, once the women were grouped by their use of mammography, differences in survival disappeared, Smith-Bindman said. "Adequate use of mammography is an ongoing problem," she said. "When women had adequate mammography, all the difference in breast cancer went away."

There is probably a combination of factors that account for the disparity in screening, Smith-Bindman said. "There may be financial and cultural barriers," she said.

One expert thinks there may be a genetic difference between black women and white women that could account for part of the difference in the severity of breast cancer seen in black women.

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"When women are equally screened, you no longer see a difference in the size of the tumor or the stage of the tumor between white and African-American women," said Dr. Mary H. Barton, an epidemiologist with the U.S. Agency for Healthcare Research and Quality, and author of an accompanying editorial.

"However, there was one marker of tumor identity that was different between African-American and white women," Barton said. "This means that it may not just be bad medical care and less frequent use of mammography that is the cause that black women die more often from breast cancer than white women. Maybe there is a genetic link."

Barton also thinks efforts are needed to increase screening among black and Hispanic women. Women and their doctors need to be reminded that getting a regular mammogram is vital.

"Let's not just focus on the doctor, let's go to the patients and show how important this is," Barton said. "That will make both of them more likely to ask for it and more likely to follow through,"

More information

For more on breast cancer, head to the U.S. National Cancer Institute (www.cancer.gov ).

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