Evidence map›Paper›PMID 38217760›Full record

ArticleCancer causes & control : CCC2024

Understanding mechanisms of racial disparities in breast cancer: an assessment of screening and regular care in the Carolina Breast Cancer Study.

Matthew R Dunn, Eman M Metwally, Sanah Vohra, Terry Hyslop, Louise M Henderson, Katherine Reeder-Hayes, Caroline A Thompson, Jennifer Elston Lafata, Melissa A Troester, Eboneé N Butler

Open access · greenAbstract read
In one paragraph

Article in Cancer causes & control : CCC, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed
1.4field-weighted citation impact, top 17% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

6 citing papers in PubMed, 5 citations in OpenAlex.

  1. Article
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  4. Applying a Novel Measure of Community-Level Healthcare Access to Assess Breast Cancer Care Timeliness.Cancer epidemiology, biomarkers & prevention : a publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive Oncology · 2025
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors at 2 institutions in 1 country.

Matthew R DunnDepartment of Epidemiology, University of North Carolina at Chapel Hill, 135 Dauer Drive, Chapel Hill, NC, 27599, USA. mdunn@unc.edu.ORCID http://orcid.org/0000-0001-7618-4983
Eman M MetwallyDepartment of Epidemiology, University of North Carolina at Chapel Hill, 135 Dauer Drive, Chapel Hill, NC, 27599, USA.
Sanah VohraLineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, NC, USA.
Terry HyslopSidney Kimmel Cancer Center, Thomas Jefferson University, Philadelphia, PA, USA.
Louise M HendersonLineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, NC, USA.
Katherine Reeder-HayesLineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, NC, USA.
Caroline A ThompsonDepartment of Epidemiology, University of North Carolina at Chapel Hill, 135 Dauer Drive, Chapel Hill, NC, 27599, USA.
Jennifer Elston LafataLineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, NC, USA.
Melissa A Troester *Department of Epidemiology, University of North Carolina at Chapel Hill, 135 Dauer Drive, Chapel Hill, NC, 27599, USA. mdunn@unc.edu.
Eboneé N Butler *Department of Epidemiology, University of North Carolina at Chapel Hill, 135 Dauer Drive, Chapel Hill, NC, 27599, USA.
University of North Carolina at Chapel Hill · USThomas Jefferson University · US

Funding

Virology Research Program (Program 4)P30CA016086 · NCI · UNIV OF NORTH CAROLINA CHAPEL HILL · PI Deborah F. Tate · 1985 to 2026
$201.5M
Tissue Procurement & PathologyP50CA058223 · NCI · UNIV OF NORTH CAROLINA CHAPEL HILL · PI BENJAMIN CARLISLE CALHOUN · 1992 to 2026
$59.3M
UNC-CH CENTER FOR ENVIRONMENTAL HEALTH &SUSCEPTIBILITYP30ES010126 · NIEHS · UNIV OF NORTH CAROLINA CHAPEL HILL · PI Hazel B Nichols · 2001 to 2026
$36.3M
Reproduction, Lactation and Hormonal Factors in Breast Cancer SubtypesP01CA151135 · NCI · ROSWELL PARK CANCER INSTITUTE CORP · PI AMBROSONE, CHRISTINE B., OLSHAN, ANDREW · 2011 to 2017
$18.1M
Cancer Control Education ProgramT32CA057726 · NCI · UNIV OF NORTH CAROLINA CHAPEL HILL · PI Melissa B Gilkey, Melissa A. Troester · 2017 to 2026
$3.7M
P53, DNA Repair Imbalance, and Immune Response in Breast Cancer Mortality DisparitiesR01CA253450 · NCI · UNIV OF NORTH CAROLINA CHAPEL HILL · PI KATHERINE A. HOADLEY, Melissa A. Troester · 2021 to 2026
$3.6M
NCI NIH HHS P01 CA151135NCI NIH HHS P01CA151135NCI NIH HHS P30 CA016086NCI NIH HHS P50 CA058223NCI NIH HHS R01 CA253450NCI NIH HHS T32 CA057726NIEHS NIH HHS P30 ES010126Susan G. Komen OGUNC1202
6 · The paper itself

Abstract

purposeScreening history influences stage at detection, but regular preventive care may also influence breast tumor diagnostic characteristics. Few studies have evaluated healthcare utilization (both screening and primary care) in racially diverse screening-eligible populations.

methodsThis analysis included 2,058 women age 45-74 (49% Black) from the Carolina Breast Cancer Study, a population-based cohort of women diagnosed with invasive breast cancer between 2008 and 2013. Screening history (threshold 0.5 mammograms per year) and pre-diagnostic healthcare utilization (i.e. regular care, based on responses to "During the past ten years, who did you usually see when you were sick or needed advice about your health?") were assessed as binary exposures. The relationship between healthcare utilization and tumor characteristics were evaluated overall and race-stratified.

resultsAmong those lacking screening, Black participants had larger tumors (5 + cm) (frequency 19.6% vs 11.5%, relative frequency difference (RFD) = 8.1%, 95% CI 2.8-13.5), but race differences were attenuated among screening-adherent participants (10.2% vs 7.0%, RFD = 3.2%, 0.2-6.2). Similar trends were observed for tumor stage and mode of detection (mammogram vs lump). Among all participants, those lacking both screening and regular care had larger tumors (21% vs 8%, RR = 2.51, 1.76-3.56) and advanced (3B +) stage (19% vs 6%, RR = 3.15, 2.15-4.63) compared to the referent category (screening-adherent and regular care). Under-use of regular care and screening was more prevalent in socioeconomically disadvantaged areas of North Carolina.

conclusionsAccess to regular care is an important safeguard for earlier detection. Our data suggest that health equity interventions should prioritize both primary care and screening.

Indexed as

Breast NeoplasmsEarly Detection of CancerHealthcare DisparitiesAgedBlack or African AmericanCohort StudiesFemaleHumansMammographyMass ScreeningMiddle AgedNorth CarolinaPatient Acceptance of Health CareWhite PeopleCancer screeningCohort studyDisparitiesHealthcareMammographyTumor presentation

Identifiers

PMID38217760
PMCPMC11045315
OpenAlexW4390840404

What OpenQuestion holds

Textmetadata
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.