Variations in breast cancer screening and health behaviors by age and race among attendees of women's health clinics

Objective: Breast cancer mortality has declined, yet disease outcomes have not improved equally across populations. Disparities may initiate early in the continuum of care, in health behavior patterns, and screening practices. We examined variations in mammography, exercise, fruit and vegetable intake, alcohol consumption, and body mass index (BMI, kg/m²) by age and race in a diverse sample of clinic patients. Methods: We analyzed survey data collected at baseline from 855 women (>40 years old) in women's health clinics, who were recruited for a risk-tailored intervention. Screening practices, health behaviors, and demographics were surveyed. Statistical analyses were performed using bivariate difference tests and multiple logistic regression. Results: Overall, 47% of the women were African American, with a mean age of 50 years. Older women were twice as likely as younger women to have had mammography within the previous year and significantly more likely than women 10 years younger to exercise at least 3 times weekly. African American women were significantly less likely than white women to exercise at least 3 times weekly, eat more than 2 servings daily of fruit and vegetables, or report a BMI of less than <25 kg/m². Mammography rates were comparable by race except among lesser-educated African American women, who showed higher rates versus comparable white women. Conclusions: New intervention models that link health behavior information with screening messages in clinical settings may be important in reducing breast cancer risk and mortality.