Dense Breast Notification Laws' Association With Outcomes in the US Population: A Cross-Sectional Study.

Published on May 1, 2021in Journal of The American College of Radiology4.268
· DOI :10.1016/J.JACR.2020.11.012
Nancy R. Kressin48
Estimated H-index: 48
(BU: Boston University),
Tracy A. Battaglia22
Estimated H-index: 22
(BU: Boston University)
+ 2 AuthorsChristine M. Gunn9
Estimated H-index: 9
(BU: Boston University)
Abstract Objective Understanding whether states’ breast density notifications are associated with desired effects, or disparities, can inform federal policy. We examined self-reported receipt of personal breast density information, breast density discussions with providers, knowledge about density’s masking effect, and association with increased breast cancer risk by state legislation status and women’s sociodemographic characteristics. Methods Cross-sectional observational population-based telephone survey of women aged > 40 years who underwent mammography within prior 2 years, had no history of breast cancer, and had heard the term “breast density.” Results Among 2,306 women, 57% received personal breast density information. Multivariate regression models adjusted for covariates indicated that women in notification states were 1.5 times more likely to receive density information, and older Black and Asian women of lower income and lower health literacy were less likely. Overall, only 39% of women discussed density with providers; women in notification states were 1.75 times as likely. Older and Asian women were less likely to have spoken with providers; women with high literacy or prior biopsy were more likely. State legislation status was not associated with differences in density knowledge, but Hispanic women and women of lower income or low health literacy had less knowledge regarding density’s masking effects; older women were more knowledgeable. Hispanic women and women of lower income or low health literacy were more likely, and middle-aged women less likely, to recognize increased breast cancer risk. Discussion Some positive effects were observed, but sociodemographic disparities suggest tailoring of future breast density communications for specific populations of women to ensure equitable understanding.
#1Lydia E. Pace (Brigham and Women's Hospital)H-Index: 18
1 CitationsSource
#1Nancy R. Kressin (BU: Boston University)H-Index: 48
#1Nancy R. Kressin (BU: Boston University)H-Index: 3
Last. Christine M. Gunn (BU: Boston University)H-Index: 9
view all 4 authors...
7 CitationsSource
#1Kelly A. Kyanko (NYU: New York University)H-Index: 8
#2Jessica R. Hoag (Yale University)H-Index: 10
Last. Cary P. Gross (Yale University)H-Index: 72
view all 7 authors...
Background To date, 38 states have enacted dense breast notification (DBN) laws mandating that mammogram reports include language informing women of risks related to dense breast tissue.
8 CitationsSource
#1Nancy M. CappelloH-Index: 2
#2Dorinda RichetelliH-Index: 1
Last. Christoph I. Lee (UW: University of Washington)H-Index: 28
view all 3 authors...
Abstract Objective We conducted a national survey to understand the impact of state-level density reporting laws on women’s level of density risk awareness and their engagement in conversations with providers regarding supplemental screening. Methods In all, 1,500 US women aged 40 to 74 years who obtained a mammogram within 2 years were surveyed in February 2018. The sampling design yielded 300 respondents in each of five groups categorized based on density reporting law features. Women were ask...
20 CitationsSource
#1Ingrid J. Hall (CDC: Centers for Disease Control and Prevention)H-Index: 23
#2Florence K. L. Tangka (CDC: Centers for Disease Control and Prevention)H-Index: 26
Last. Nancy Breen (United States Department of Energy Office of Science)H-Index: 57
view all 6 authors...
INTRODUCTION: We examined the prevalence of cancer screening reported in 2015 among US adults, adjusted for important sociodemographic and access-to-care variables. By using data from the National Health Interview Survey (NHIS) for 2000 through 2015, we examined trends in prevalence of cancer screening that adhered to US Preventive Services Task Force screening recommendations in order to monitor screening progress among traditionally underserved population subgroups. METHODS: We analyzed NHIS d...
69 CitationsSource
#1Jong-Myon Bae (Jeju National University)H-Index: 24
#2Eun Hee Kim (Jeju National University)H-Index: 10
OBJECTIVES: The established theory that breast density is an independent predictor of breast cancer risk is based on studies targeting white women in the West. More Asian women than Western women have dense breasts, but the incidence of breast cancer is lower among Asian women. This meta-analysis investigated the association between breast density in mammography and breast cancer risk in Asian women. METHODS: PubMed and Scopus were searched, and the final date of publication was set as December ...
26 CitationsSource
#1Nancy R. Kressin (BU: Boston University)H-Index: 48
#2Christine M. Gunn (BU: Boston University)H-Index: 9
Last. Tracy A. Battaglia (BU: Boston University)H-Index: 20
view all 3 authors...
40 CitationsSource
Purpose Legislation mandating disclosure of breast density (BD) information has passed in 21 states; however, actual awareness of BD and knowledge of its impact on breast cancer detection and risk are unknown. Methods We conducted a national cross-sectional survey administered in English and Spanish using a probability-based sample of screening-age women, with oversampling of Connecticut, the only state with BD legislation in effect for > 1 year before the survey. Results Of 2,311 women surveyed...
70 CitationsSource
#1Tetine Sentell (UH: University of Hawaii)H-Index: 20
#2Janice Y. Tsoh (UCSF: University of California, San Francisco)H-Index: 28
Last. Kathryn L. Braun (UH: University of Hawaii)H-Index: 35
view all 5 authors...
Objectives Cancer is the leading cause of death among Asian Americans. Chinese Americans comprise the largest Asian American ethnic group. Low health literacy (LHL) is associated with lower cancer screening rates, but this association has not been studied in Chinese Americans. We examined the relationship between LHL and meeting US Preventive Service Task Force (USPSTF) guidelines for cervical, colorectal and breast cancer screening among Chinese Americans. Design Observational study of Chinese ...
41 CitationsSource
#1Bijou R. Hunt (Mount Sinai Hospital)H-Index: 12
#2Steve Whitman (Mount Sinai Hospital)H-Index: 7
Last. Marc HurlbertH-Index: 14
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A B S T R A C T Introduction: This paper presents race-specific breast cancer mortality rates and the corresponding rate ratios for the 50 largest U.S. cities for each of the 5-year intervals between 1990 and 2009. Methods: The 50 largest cities in the U.S. were the units of analysis. Numerator data were abstracted from national death files where the cause was malignant neoplasm of the breast (ICD-9 = 174 and ICD-10 = C50) for women. Population-based denominators were obtained from the U.S. Cens...
122 CitationsSource
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