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Racial Differences in Communicating and Understanding Mammogram Results

Abnormal mammogram results were more likely to be miscommunicated to African American woman than to white women.

Breast cancer tends to be diagnosed at later stages and to have poorer outcomes in African American (AA) women than in white women. Race-related differences in the screening process could contribute to this discrepancy. Researchers investigated whether test results were adequately communicated to AA and white women who underwent mammography screening at one of five urban facilities. The 411 AA and 734 white participants (age range, 40–79) were later contacted (99% within 6 months of the screening) and asked whether they had received their results, what the results were, and what they had been asked to do for follow-up.

Overall, 1002 women reported receiving their results, and 143 reported not receiving them. Twenty-three women reported results that disagreed with the records, with 18 women believing their mammograms were normal when in fact they were not. The proportions of normal and abnormal results were similar between the two racial groups. However, in AA women, abnormal results were more likely to be inadequately communicated than were normal results: In 31% of AA women with abnormal mammograms and 19% with normal mammograms, the self-reported results differed from the actual mammogram reports. In white women, there was no such difference in adequacy of communicating abnormal versus normal results.

Comment: We all know that what we say isn’t always what our patients hear. In considering this problem as it applies to racial disparities in screening mammography, the authors did not determine whether the discrepancies were due to miscommunication, misperception, or other factors. The ideal situation allows the radiologist to interpret the mammogram, communicate the results, and initiate follow-up on the spot. This situation is rare, but misunderstandings can still be averted by tailoring communication strategies to diverse patient groups, documenting communications, designating a staff member to case-manage women with abnormal results, and asking patients to repeat what they have comprehended.

— Diane E. Judge, APN/CNP

Published in Journal Watch Women's Health April 19, 2007

Citation(s):

Jones BA et al. Adequacy of communicating results from screening mammograms to African American and White women. Am J Public Health 2007 Mar; 97:531-8.

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