Racial Disparities in Screening Mammography in the United States: A Systematic Review and Meta-analysis

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• 作者：Ahmed T. Ahmed ; MB ; BCh^a ; ^{Ahmed.Ahmed1@mayo.edu} ; Brian T. Welch ; MD^b ; Waleed Brinjikji ; MD^b ; Wigdan H. Farah ; MBBS^a ; Tara L. Henrichsen ; MD^b ; M. Hassan Murad ; MD^a ; John M. Knudsen ; MD^b
• 关键词：Mammography ; racial ; disparities ; systematic review ; meta-analysis
• 刊名：Journal of the American College of Radiology
• 出版年：2017
• 出版时间：February 2017
• 年：2017
• 卷：14
• 期：2
• 页码：157-165.e9
• 全文大小：1695 K
• 卷排序：14

文摘

Many studies have suggested that disparities exist in the use of medical screening tests. The purpose of this study was to assess racial disparities in screening mammography in the United States via a systematic review and meta-analysis.MethodsWe searched MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials, Cochrane Database of Systematic Reviews, and Scopus for comparative studies published between 1946 and 2015 comparing utilization of mammography among various racial groups. Two independent reviewers extracted data and appraised study. Meta-analysis was conducted when appropriate using the random-effects model.ResultsA total of 5,818,380 patients were included across 39 relevant studies; 43.1% of patients were white, 33.3% were black, 17.4% were Hispanic, and 6.2% were Asian/Pacific Islander. Black and Hispanic populations had lower odds of utilizing screening mammography when compared with the white population (odds ratio [OR] = 0.81; 95% confidence interval [CI], 0.72-0.91; I2 = 89.4% and OR = 0.83; 95% CI, 0.74-0.93, respectively). For African Americans, these disparities were present in both the 40 to 65 age group and the >65 age group; for Hispanics, these differences were present only in the 40 to 65 age group. There was no difference in mammography utilization between Asians/Pacific Islanders and whites (OR = 1.82; 95% CI, 0.09-38.41).ConclusionsRacial disparities in utilization of screening mammography are evident in black and Hispanic populations in the United States. Further studies are needed to understand reasons for disparities, trends over time, and the effectiveness of interventions targeting these disparities.