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Jillian Jacobellis, PhD, MS and Gary Cutter, PhD

Jillian Jacobellis is with the Colorado Department of Public Health and Environment, Denver, and the Department of Preventive Medicine and Biometrics, School of Medicine, University of Colorado Health Science Center. Gary Cutter is with the Center for Research Methodology and Biometrics, AMC Cancer Research Center, and the University of Nevada, Reno.

Correspondence: Requests for reprints should be sent to Jillian Jacobellis, PhD, MS, Colorado Department of Public Health and Environment, 4300 Cherry Creek Dr S, Denver, CO 80246-1530 (e-mail: jillian.jacobellis{at}state.co.us).

Objectives. We examined the effect of routine screening on breast cancer staging by race/ethnicity.

Methods. We used a 1990 to 1998 mammography database (N = 5182) of metropolitan Denver, Colo, women to examine each racial/ethnic cohort's incident cancer cases (n = 1902) and tumor stage distribution given similar patterns of routine screening use.

Results. Regardless of race/ethnicity, women participating in routine screenings had earlier-stage disease by 5 to 13 percentage points. After control for possible confounding factors, White women were more likely to have early-stage disease compared with Black and Hispanic women.

Conclusions. Lack of screening coverage in certain racial/ethnic populations has often been cited as a reason for tumor stage differences at detection. In this study, correcting for screening did not completely reduce stage differentials among Black and Hispanic women. (Am J Public Health. 2002;92:1144–1150)

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