Abstract
BACKGROUND: Hispanic/Latina women are less likely to be diagnosed with local stage breast cancer than White women. Additionally, foreign-born women have lower mammography rates than US-born women. We evaluated the combined effect of birthplace and race/ethnicity on screening habits of women at higher-than-average risk of breast cancer. METHODS: Multinomial logistic regression was used to evaluate breast cancer screening in 44,524 women in the Sister Study cohort. Screening methods ascertained at enrollment (2003-2009) included mammography, ultrasound, and magnetic resonance imaging. Timing of screening was assessed as recently (≤2 years ago), formerly (>2 years ago), and never screened. Adjustments included sociodemographic, socioeconomic, and health variables. RESULTS: Most women in the sample were US-born non-Hispanic/Latina White (92%), were ≥50 years old (73%), had one first-degree female relative with breast cancer (73%), and were screened in the past two years (97%). US-born Hispanic/Latina women had higher odds (odds ratio [OR] = 1.47, 95% confidence interval [CI] = 1.08-2.00) than US-born non-Hispanic/Latina White women of not having received a breast cancer screening in the past 2 years, relative to a recent screening. Similarly, foreign-born Hispanic/Latina women had higher odds (OR = 1.63, 95% CI = 1.10-2.41) than US-born non-Hispanic/Latina White women of never having received a breast cancer screening. CONCLUSION: We observed that Hispanic/Latina women have higher odds of never and dated breast cancer screenings compared to US-born White women. Birthplace and race/ethnicity each contribute to disparities in who receives preventative health care in the United States. It is critical to include birthplace when evaluating health behaviors in minority groups.