Depression May Decrease Breast Cancer Screening

WASHINGTON—A definite link exists between mammography screening and lessened breast cancer mortality, but black women do not take full advantage of cancer screening, according to Janice S. Emerson, research associate, Center for Health Research, Tennessee State University, Nashville. Speaking at the American Psychological Association Conference on Enhancing Outcomes in Women’s Health, she presented findings from an HCFA-funded project, led by Dr. Baqar A. Husaini.

In addition to cost and inconvenience, Ms. Emerson noted, researchers have ascribed this failure of black women to seek mammography screening to other factors, including lack of knowledge about cancer, lack of knowledge about who needs a mammogram, and health care providers’ failure to recommend that women get mammograms. But recent data show that depression is a significant factor as well. Ms. Emerson described a study that examined the relationship between depression and screening mammography as well as the effect of social support on lessening the former and increasing the latter.

An experimental group of 288 black women at least 40 years old received an educational intervention informing them about mammography. A control group of 56 comparable women received no such intervention. Each subject underwent an evaluation for depression and answered questions about her mammography practices and the sources and degree of social support in her daily life, in general and regarding mammograms.

Women who had not gotten needed mammograms showed "a great deal more depressive symptoms" than those who had, Ms. Emerson reported.

Social support specifically related to mammograms, such as participating in discussions about mammography’s benefits, greatly increased the likelihood that a woman would get screened, she said. General social support, however, as measured by the number of friends women mentioned, had no effect on that likelihood except indirectly, insofar as it helped lessen depression.

Interventions aimed at increasing mammography among black women should therefore focus not only on conveying information about mammograms but on the psychological context in which the women live, Ms. Emerson said.