Ethnic disparities in size of breast cancer tumor at diagnosis: The role of screening mammography

Evaluating ethnic disparities in the diagnosis of breast cancer can help illustrate areas for health care improvement and perhaps increase long-term survival. The objective of this study was to investigate the influence of screening mammography on tumor size between older Hispanic and non-Hispanic white women diagnosed with breast cancer. Data were obtained from the linked SEER-Medicare database. We hypothesized that older Hispanic women would present with larger tumors and that this association could be explained by their lower use of screening services in the years before diagnosis. The study had four principal findings. Hispanic women are more likely to be diagnosed with larger tumors than non-Hispanic white women. This association persists after controlling for socio-economic status. There is no evidence that tumor biology, at least in terms of tumor grade, explains this relationship. The association is attributed to different levels of mammography use by Hispanic and non-Hispanic white women.