One is that while African American women may get screened, they may also be less likely to have a timely follow-up visit when their mammogram results are abnormal, according to lead study author Dr. Franco Sassi.

"African-American women do appear to receive less, or less adequate, follow-up of screening test results," Sassi, a researcher at the London School of Economics and Political Science in the U.K., told Reuters Health.

This may be partly related to a lack of health insurance, he said, but that's unlikely to be the main reason, because uninsured women are less likely to be screened in the first place.

Sassi and his colleagues based their findings on data from cancer registries in five U.S. states for the years 1990 through 1998, as well as federal statistics on mammography screening for the same time period.

Over time, the researchers found, screening rates ticked upward for all three racial groups, particularly Hispanic women. The rate of early diagnosis also climbed.

But the benefit was less pronounced among African American women, the study found. While mammography screening doubled the chances of early diagnosis among white and Hispanic women, it raised those odds by only 70 percent among African American women.

The reasons, according to Sassi's team, are likely to involve a "complex interplay" of factors.

It's possible, they note, that some of the highest-risk African American women are not getting screened. Research has shown, for example, that African American women with a family history of breast or ovarian cancer are less likely than their white counterparts to be tested for the genes linked to familial breast cancer.

African American women are also more likely than white or Hispanic women to be obese, which has been linked to later breast cancer diagnosis, even when women get screened.

Sassi noted that government programs to help low-income women get mammograms have "done a lot" to increase screening rates among minority women. But funds for follow-up diagnosis and treatment have been limited, and are still "less than ideal," he said.

Policy makers, according to Sassi, may need to focus not only on improving breast cancer screening, but also on ensuring that mammography leads to earlier diagnosis.

SOURCE: American Journal of Public Health, December 2006.

Copyright © 2006 Reuters Limited. All rights reserved. Republication or redistribution of Reuters content, including by framing or similar means, is expressly prohibited without the prior written consent of Reuters. Reuters shall not be liable for any errors or delays in the content, or for any actions taken in reliance thereon. Reuters and the Reuters sphere logo are registered trademarks and trademarks of the Reuters group of companies around the world.

Many women may not recognize bulimia symptoms

Last Updated: 2006-12-04 9:50:51 -0400 (Reuters Health)

By Amy Norton

NEW YORK (Reuters Health) - Many women may fail to recognize bulimia symptoms in themselves, particularly if they don't go to the extremes of self-induced vomiting, new research suggests.

In a study of 158 women with bulimia-type eating disorders, Australian researchers found that nearly half did not acknowledge a problem with their eating. This was particularly true of those who did not vomit to control their weight.

Bulimia is widely known as a "binge-purge" eating disorder, in which a person goes through cycles of excessive eating followed by purging -- through either vomiting or abusing laxatives and diuretics.

But there are also non-purging forms of bulimia, where tactics like excessive exercise or strict dieting are used to counter binge-eating episodes.

Still other people have certain symptoms of bulimia but fall short of all the criteria used to diagnose the disorder; they may fall into the category of "eating disorder not otherwise specified," or EDNOS.

The new study, published in the International Journal of Eating Disorders, focused on women with "bulimic-type" eating disorders. This included those with purging or non-purging bulimia, as well as women with EDNOS. Some women in the latter group were diagnosed with binge-eating disorder, which involves excessive eating but no purging to compensate]

The researchers presented the women with a vignette about a woman with bulimia, and then asked the women if they might have a problem similar to that of the character. In all, 52 percent said they might, while 48 percent denied that they did.

Women who used self-induced vomiting were nearly six times more likely than other women to recognize that they had a problem, the study found.

"Our research suggests that, when it comes to bulimia-type eating disorders, women tend to think that if there is not vomiting involved, then it's not a problem," said lead study author Dr. Jonathan Mond, a senior research scientist at James Cook University in Townsville, Australia.

This is partly due to media portrayals of eating disorders, which typically highlight anorexia and purging-type bulimia, Mond told Reuters Health.

But there's also a general perception that excessive exercise and strict calorie-cutting are acceptable, or even "desirable," behaviors, he added.

What's needed, Mond said, is greater awareness of the nopurging forms of bulimia, as well as other bulimia-type eating problems -- including binge-eating disorder and "compensatory" disorder, where a person purges or exercises excessively, for example, but does not binge.

And that awareness needs to spread not only in the general public, Mond noted, but among doctors and other health professionals.

In some cases where a woman with one of these eating disorders does seek treatment, he explained, the doctor may treat what's seen as the "true" problem -- such as depression or anxiety -- leaving the eating disorder inadequately addressed.

SOURCE: International Journal of Eating Disorders, December 2006.

Copyright © 2006 Reuters Limited. All rights reserved. Republication or redistribution of Reuters content, including by framing or similar means, is expressly prohibited without the prior written consent of Reuters. Reuters shall not be liable for any errors or delays in the content, or for any actions taken in reliance thereon. Reuters and the Reuters sphere logo are registered trademarks and trademarks of the Reuters group of companies around the world.