Geographic patterns of change over time in mammography: Differences between Black and White U.S. Medicare enrollees

- Changes in screening mammography are not consistent across the U.S.
- Screening mammography decreased more in White women overall.
- Black women had higher magnitude increases and decreases in screening by region.
- Changes in screening among White women demonstrate more clustering across the U.S.
- Screening disparities existed for Black women compared to Whites in 2008 and 2012.

U.S. Black women have higher breast cancer mortality compared to White women while their rate of ever having a mammogram has become equal to or slightly surpassed that of Whites. We mapped the distribution of change in screening mammography for Black and White female Medicare enrollees ages 67-69 from 2008 to 2012 by hospital referral region across the contiguous U.S., performed cluster analysis to assess spatial autocorrelation, and examined the screening differences between these groups in 2008 and 2012 respectively. Changes in screening mammography are not consistent across the U.S.: Black and White women have increased and decreased their use of mammography in different regions and Black women's change patterns vary more widely.