• L M Reisch, M B Barton, S W Fletcher, W Kreuter, and J G Elmore.
• Departments of Medicine, University of Washington School of Medicine, Seattle, Washington, USA.
• J Gen Intern Med. 2000 Apr 1; 15 (4): 229234229-34.

ObjectiveTo examine racial differences in breast cancer screening in an HMO that provides screening at no cost.DesignRetrospective cohort study of breast cancer screening among African-American and white women. Breast cancer screening information was extracted from computerized medical records.SettingA large HMO in New England.Patients/ParticipantsWhite and African-American women (N = 2,072) enrolled for at least 10 years in the HMO.Main ResultsPrimary care clinicians documented recommending a screening mammogram significantly more often for African Americans than whites (70% vs 64%; P <.001). During the 10-year period, on average, white women obtained more mammograms (4.49 vs 3.93; P <.0001) and clinical breast examinations (5.35 vs 4.92; P <.01) than African-American women. However, a woman's race was no longer a statistically significant predictor of breast cancer screening after adjustment for differences in age, estimated household income, estrogen use, and body mass index (adjusted number of mammograms, 4.47 vs 4.25, P =.17; and adjusted number of clinical breast examinations, 5.35 vs 5. 31, P =.87).ConclusionsIn this HMO, African-American and white women obtained breast cancer screening at similar rates. Comparisons with national data showed much higher screening rates in this HMO for both white and African-American women.

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