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The more health-related needs a woman has, the less likely she is to get an annual mammogram. That was the result of a study published by the Centers for Disease Control, and one that highlights the challenges women in lower socioeconomic situations face trying to access health care.

“Unfortunately, this doesn’t surprise me,” said Shannon Falcon, MD, a radiologist specializing in breast imaging in the Department of Diagnostic Imaging and Interventional Radiology at Moffitt Cancer Center. “We have data showing women with lower economic status and education may not be accessing mammography, and this study validates our suspicions that there are other social factors limiting women’s access, as well.”

The study points to a lack of transportation and social isolation as large barriers to this patient population. Finances also play a part and include more than just the cost of a mammogram, which is usually covered by insurance.

There’s a cost of childcare required to allow a mother to get to an appointment or they may not be able to take time off of work for a mammogram.
Shannon Falcon, MD

“There’s a cost of childcare required to allow a mother to get to an appointment or they may not be able to take time off of work for a mammogram,” Falcon said.

The study found that mammography prevalence was 83.2% for women between 50 and 74 with no adverse health-related social needs. Among women in the same age bracket with three or more of those needs, the prevalence was 65.7%.

Breast cancer causes more than 40,000 deaths among women in the U.S. each year, according to the CDC, but breast cancer death rates have been decreasing. However, that decrease is not the same for all ethnicities and cultural backgrounds. Black women and women with lower incomes, for example, are more likely to die from breast cancer.

Authors of the study wrote that the findings were consistent with previous studies showing a relationship between lower mammography use and these health-related social needs, which include lower educational attainment and income and not having a usual source of health care. Being uninsured was also a factor.

While the news is upsetting, there are steps medical professionals and cancer centers are taking to reach these patients and to encourage regular screening.

“A lot of public health institutions are pushing to educate and teach women that they are at risk, if not more so, for breast cancer,” Falcon said. “They don’t always realize that they have this risk, especially non-Hispanic Black women who often present earlier and with a more aggressive disease.”

Falcon said Moffitt is working to educate women across the board about the importance of mammography screenings so that physicians can detect it earlier, when it’s easiest to treat. All women, regardless of race, should begin getting annual mammograms at age 40, Falcon said. Those with increased risks may need to begin much earlier, depending on health-related social factors.

“We know that when we screen regularly, we have a better chance to find cancer earlier and smaller, when we are able to treat it more easily and save the most lives,” Falcon said.