Evaluating the effects of revised breast and cervical cancer screening guidelines on Black women's cancer screening behavior

Background Timely cancer screening remains the most effective method to reduce the burden of breast (BrCa) and cervical (CxCa) cancer. Recent changes to BrCa and CxCa screening guidelines reflected increased age of initiation and lengthened screening intervals.  The effect on women’s screening behavior is unclear, and it is important to examine implications for BrCa and CxCa disparities. Purpose Black women’s screening behaviors were examined to determine the effects of updated recommendations. Methods As part of a larger community-based participatory research (CBPR) project, surveys were administered to adult males and females in participating Black churches from 2006-2013 (n=1,904 females). Items included assessment of demographic and cancer screening information. For mammography behavior, women with BrCa or diagnostic mammograms were removed from analysis (n=256). The frequency of mammography completion in 2006-2009 was compared to the 2010-2013 rates using chi square. Women with CxCa were removed (n= 43) and a similar analysis of Pap test completion during the 2006-2011 and 2012-2013 time periods was conducted. Results There were no significant differences in the rates of either test after the updated recommendations, but a large portion of women <50 continued to complete annual mammograms (51%). Black women’s BrCa and CxCa screening practices have remained largely unchanged despite updated screening recommendations. Discussion For CxCa, the results indicate a potential lag in the adoption of updated prevention practices. Stability in BrCa screening behavior may be due to the controversy concerning the updated guidelines. More research is needed to monitor implications of updated guidelines on screening behavior.