The Effect of Risk on Changes in Breast Cancer Screening Rates in Los Angeles, 1988-1990

Presents population-based survey results of screening for breast cancer in 1988 and 1990 in three socioeconomically diverse Los Angeles communities. The survey showed that women at higher risk of breast cancer (i.e., those with a positive family history) participated in less breast cancer screening than did a comparison group of women who had no family history of breast cancer or who had a benign breast disease. This was especially true for family-history-positive minority women and women aged 65 and older. In 1990, for example, mammograms for the prior year were reported by only 39 percent of women with a positive family history, compared with 54 percent of women with benign breast disease and 35 percent of women without these risks. This article demonstrates that screening tends to be done among women with a low prevalence of disease and not among those in the highest-risk pool. The authors state that physicians can play an important role in promoting appropriate and effective screening by identifying and counseling higher-risk women.