Breast and cervical cancer screening for Puerto Ricans, African Americans, and non-Hispanic whites attending inner-city family practice centers.

OBJECTIVES

Disparities exist for breast and cervical cancer screening among racial/ ethnic groups and low-income women. This study determines racial/ethnic variation in: 1) staging readiness for mammography, Pap smears, and clinical breast exam (CBE); 2) identifying patterns of adherence; and 3) determining sociodemographics associated with compliance with all three exams.

DESIGN

Cross-sectional.

SETTING

Two urban family medicine clinics.

PATIENTS: A consecutive sample of 343 women presenting for care.

INTERVENTIONS: Women were staged (maintainers, actors, contemplators, precontemplators, relapse contemplators, and relapse precontemplators) according to self-reported receipt of mammography, CBEs, and Pap smears.

MAIN OUTCOME MEASURES: Adherence across exams was assessed. Sociodemographics were compared among racial/ethnic groups for women adherent with all three exams.

RESULTS

Sixty-one percent were adherent with mammography, 93% with Pap smears, and 67% with CBEs. Thirty percent were contemplating mammography. Fifty-eight percent of Puerto Rican women were adherent with CBEs compared to 68.6% of African American and 78.5% of non-Hispanic White women. Puerto Rican women were less likely to be maintainers of CBE and more likely to be precontemplators and relapsers than non-Hispanic White women (P=.004). Forty-eight percent were adherent with all three exams. Puerto Rican women compliant with all three screens were younger and less educated than African American and non-Hispanic White

CONCLUSIONS

Racial/ethnic differences in screening patterns exist among women attending urban family practice centers. Primary care providers must be culturally sensitive when recommending screening and can use staging as a tool to target women most receptive to intervention.