Purpose/Objectives: To identify the relationships among potential access, realized access, and stage at diagnosis of breast cancer in African American and Caucasian women receiving care within an equal economic access healthcare system. DESIGN: Descriptive-comparative design.
Setting: Department of Defense Military Health System.
Sample: 62 African American and 573 Caucasian women (ages 25-97) diagnosed with breast cancer over a 10-year period. METHODS: Secondary analysis using tumor registry records data.
Main Research Variables: Economic, potential, and realized access and stage at diagnosis of breast cancer.
Findings: When compared to Caucasian women, African American women were diagnosed at later stages, were younger when diagnosed, were from a lower socioeconomic status, had a higher percentage of incidental breast self-examination-discovered abnormalities, and had a lower percentage of mammogram-discovered abnormalities.
Conclusions: Economic access to care did not always result in early diagnosis. Other factors such as age, race, socioeconomic status, and means of discovery influenced diagnosis outcomes.
Implications for Nursing Practice: Interventions aimed at increasing participation in breast health programs also should focus on noneconomic aspects of access such as help-seeking behaviors and perceptions of access to care. Additional studies should be conducted to evaluate adherence to breast cancer screening guidelines by women receiving care within equal economic access healthcare systems.