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Paul Z. Siegel, MD, MPH, Judith R. Qualters, PhD, Paul D. Mowery, PhD, Stefano Campostrini, PhD, Craig Leutzinger, David V. McQueen, ScD and Donald K. Blackman, PhD

Paul Z. Siegel and Craig Leutzinger are with the Division of Adult and Community Health and David V. McQueen is with the Office of the Director, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention (CDC), Atlanta, Ga. Judith R. Qualters is with the Division of Environmental Hazards and Health Effects, National Center for Environmental Health, CDC. Paul D. Mowery is with the Research Triangle Institute, Research Triangle Park, NC. Stefano Campostrini is with the Department of Statistical Sciences, University of Padova, Padova, Italy. Donald K. Blackman is with the Division of Cancer Prevention and Control, CDC.

Correspondence: Requests for reprints should be sent to Paul Z. Siegel, MD, MPH, Mail Stop K-30, Centers for Disease Control and Prevention, Atlanta, GA 30341-3724 (e-mail: pzs1{at}cdc.gov).

In our article, we presented the results of a study from which we concluded that a change in the 1992 BRFSS questionnaire wording caused a reduction in the measured prevalence of mammography screening, especially among Black women and women with less than a high school education. Berumen points out that the Breast and Cervical Cancer Mortality Prevention Act, passed by Congress in 1990, may have increased mammography use among low-income women and thereby caused some of the effect that we attributed to questionnaire wording.

It is important to recognize that although the Prevention Act was passed in 1990, screening programs implemented on the basis of this legislation developed gradually. Specifically, funding began in 1991 and was initially received by only 8 states. Few services were delivered by these funded states before mid-1992, so we believe it is highly unlikely that the Prevention Act had any effect on the results of our study.

To further put into perspective the population-based impact of this legislation, we would like to point out that even in 2001, the Centers for Disease Control and Prevention’s Division of Cancer Prevention and Control estimated that about 18% of the Prevention Act’s target population received screening through Prevention Act funds, since appropriations were not available to provide screening services to additional women.

This Article Extract Full Text (PDF) Submit a response Purchase Article View Shopping Cart Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Services Similar articles in this journal Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Siegel, P. Z. Articles by Blackman, D. K. Search for Related Content PubMed Articles by Siegel, P. Z. Articles by Blackman, D. K. Related Collections Screening Surveys Women's Health