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Alacey Berumen, MNM, PhDc

Requests for reprints should be sent to Alacey Berumen, MNM PhDc, 2255 S Oneida St, Denver, CO 80224 (e-mail: aberumen{at}cancer.org).

In a study published in the May 2001 issue of the Journal, Seigel et al. based their findings on the downturn in mammography rates in the 1992 Behavioral Risk Factor Surveillance System on the fact that wording of the questionnaire had changed.¹ I believe that some outside influences may have contributed to higher mammogram rates in the first comparison year of 1990/91.

In 1990, Congress passed the Breast and Cervical Cancer Mortality Prevention Act, taking an important step to ensure that more cases of cancer in women were detected early. This law authorized a breast and cervical cancer screening program for low-income, uninsured, and underinsured women who do not have health insurance coverage and who do not qualify for Medicaid or Medicare. Immediately after passage of this act, media campaigns encouraged screening, targeting of the underserved populations increased, and large numbers of women were screened.

Siegel et al. focused on African American women with less than a high school education who had mammograms during 1990, 1991, and 1992. Although the questionnaire wording was changed, I believe that the focus on increasing the screening of underserved women in 1990 and 1991 also had an impact on the data. Historically, women without high school diplomas have been blue-collar workers who may or may not have health insurance as a benefit. Would the screening numbers have been as high had this program not been available? Can the data be replicated if a comparison is made with previous years, when the Prevention Act did not provide for screening?

Reference

1. Siegel PZ, Qualters JR, Mowery PD, Campostrini S, Leutzinger C, McQueen DV. Subgroup-specific effects of questionnaire wording on population-based estimates of mammography prevalence. Am J Public Health.2001;91:817–820.[Abstract]

This Article Extract Full Text (PDF) Submit a response 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 Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Berumen, A. Search for Related Content PubMed PubMed Citation Articles by Berumen, A. Related Collections Screening Surveys Women's Health