About one-third of socially vulnerable women missing recommended mammograms, CDC says
Lack of transportation and social isolation were linked to lower mammography use.
LOS ANGELES -- Thousands of women between ages 50 and 74 are not receiving life-saving mammograms, according to new federal data.
Researchers from the Centers for Disease Control and Prevention looked at the prevalence of mammography use over a two-year period, in a report published Tuesday.
Mammography use varied by state and sociodemographics, but the study found the more health-related social needs (HRSNs) a woman had, the less likely she was to get a mammogram.
HRSNs are barriers that impact a person's health or health care access with examples including food insecurity and lack of access to reliable transportation. These are sometimes referred to as social determinants of health (SDOHs).
For women between ages 50 and 74, mammography prevalence was 83.2% for women with no adverse SDOHs or HRSNs. However, among women in that age bracket with three or more SDOHs or HRSNs, the prevalence was 65.7%.
Social isolation, life dissatisfaction, lost or reduced hours of employment, being on food stamps, lack of reliable public transportation and cost barriers were all associated with not having had a mammogram within the previous two years.
The authors said this was consistent with findings from previous studies showing associations between lower mammography use and HRSNs, including lower educational attainment and income, not having a usual source of health care and being uninsured.
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"We have to address these health-related social needs to help women get the mammograms they need," CDC Chief Medical Officer Dr. Debra Houry said in a statement. "Identifying these challenges and coordinating efforts between health care, social services, community organizations, and public health to help address these needs could improve efforts to increase breast cancer screening and ultimately save these tragic losses to families."
Breast cancer causes more than 40,000 deaths among women in the U.S. each year, according to the CDC. Breast cancer death rates have been decreasing, but the report noted this has not been equitable across all groups. For example, Black women and women with low incomes are more likely to die from breast cancer.
However, evidence has shown that mammograms reduce breast cancer deaths. A multi-national study published in 2020, led by Queen Mary University in London, found that women who participated in mammography screenings had a 41% reduced risk of dying of breast cancer within 10 years and a 25% reduction in the rate of advanced breast cancers.
The U.S. Preventive Services Task Force, the group of specialists that set national guidelines for preventive care in the U.S., currently had recommended women between ages 50 and 74 receive a mammogram every two years during the dates that were studied. The Task Force now recommends all women should get screened for breast cancer every other year, starting at age 40 with final guidelines expected shortly.
"If we are to achieve higher breast cancer screening for all women, we have to look at all the possible challenges women face in getting mammograms," said Lisa Richardson, director of the CDC's Division of Cancer Prevention and Control, in a statement. "Health care providers can now assess whether women have health-related social needs and help women get the services they need. Every woman should be able to get screened for breast cancer without barriers."
