Misclassification of Survey Responses and Black-White Disparity in Mammography Use, Behavioral Risk Factor Surveillance System, 1995-2006
2011

Racial Disparities in Mammography Use

Sample size: 156982 publication Evidence: moderate

Author Information

Author(s): Njai Rashid, Siegel Paul Z., Miller Jacqueline W., Liao Youlian

Primary Institution: Centers for Disease Control and Prevention

Hypothesis

Misclassification of survey responses may obscure actual racial disparities in mammography use.

Conclusion

Self-reported data overestimate mammography use, particularly for black women, and adjustments reveal that neither group met the Healthy People 2010 objective by 2006.

Supporting Evidence

  • After adjustment for misclassification, the percentage of women aged 40 years or older who reported receiving a mammogram was lower than previously reported.
  • By 2006, neither white nor black women had reached the Healthy People 2010 objective of 70% mammography use.
  • Black women had a lower specificity in self-reported mammography use compared to white women.

Takeaway

The study found that when women were asked about mammograms, many black women said they had one when they actually hadn't, making it seem like they were getting checked as often as white women, which wasn't true.

Methodology

The study adjusted BRFSS data for age and misclassification using established sensitivity and specificity values.

Potential Biases

The sensitivity and specificity measures did not account for socioeconomic status or other factors affecting mammography use.

Limitations

The validity measures used for adjustments were not based on nationally representative samples, and the BRFSS questionnaire did not distinguish between screening and diagnostic mammograms.

Participant Demographics

Participants included non-Hispanic black and white women aged 40 years or older.

Statistical Information

P-Value

p<0.001

Statistical Significance

p<0.001

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