(HealthDay News) — Mammography use is still higher among White patients than among American Indian patients, but the gap is narrowing due to declining mammography use in White patients, according to a study published in the American Journal of Preventive Medicine.

Researchers assessed mammography trends and examined the impact of race, urbanicity, and income on long-term mammography use. The analysis included 2005 to 2019 claims data for 457,476 female Medicare fee-for-service beneficiaries (aged 40 to 89 years) residing in Arizona, California, New Mexico, Oklahoma, and Washington.

Most patients (61.8%) did not have a mammogram during the study period. The average annual percentage of patients who underwent mammography was 18.2% overall, 19.5% for White patients, 15.9% for American Indian patients, and 13.4% for other patients.

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In the overall cohort, annual age-adjusted mammography use declined from 205 per 1000 in 2005 to 165 per 1000 in 2019. Annual age-adjusted mammography use per 1000 declined significantly for White patients (β= −3.06, P <.001) and patients of other races (β= −3.28, P <.001) but not for American Indian patients (β= −0.65, P =.202).

In a multivariable analysis, American Indian patients had lower odds of undergoing mammography than White patients (odds ratio [OR], 0.87; 99% CI, 0.81-0.93). Patients of other races also had lower odds of undergoing mammography than White patients (OR, 0.86; 99% CI, 0.84-0.87).

Across all urbanicity categories (metropolitan, micropolitan, small town, and rural), the odds of mammography use were lower for American Indian patients than for White patients. For example, among patients in rural areas, the OR was 0.96 (95% CI, 0.77-1.20) for American Indian patients and 1.47 (99% CI, 1.39-1.57) for White patients.

Residing in higher-income communities was only associated with higher mammography use for White patients (OR, 1.31; 99% CI, 1.28-1.34).

“The disparity in annual age-adjusted mammography use between American Indian and White women narrowed between 2005 and 2019,” the researchers concluded. “However, the association of urbanicity and community income on mammography use differs substantially between American Indian and White women. Policies to reduce disparities need to consider these differences.”

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