Mobile Mammography Participation Among Medically Underserved Women: A Systematic Review

Abstract

IntroductionAlthough breast cancer deaths have declined, the mortality rate among women from medically underserved communities is disproportionally high. Screening mammography is the most effective tool for detecting breast cancer in its early stages, yet many women from medically underserved communities do not have adequate access to screening mammograms. Mobile mammography may be able to bridge this gap by providing screening mammograms at no cost or low cost and delivering services to women in their own neighborhoods, thus eliminating cost and transportation barriers. The objective of this systematic review was to describe the scope and impact of mobile mammography programs in promoting mammographic screening participation among medically underserved women.MethodsWe searched electronic databases for English-language articles published in the United States from January 2010 through March 2018 by using the terms “mobile health unit,” “mammogram,” “mammography,” and “breast cancer screening.” Of the 93 articles initially identified, we screened 55; 16 were eligible to be assessed and 10 qualified for full text review and data extraction. Each study was coded for study purpose, research design, data collection, population targeted, location, sample size, outcomes, predictors, analytical methods, and findings.ResultsOf the 10 studies that qualified for review, 4 compared mobile mammography users with users of fixed units, and the other 6 characterized mobile mammography users only. All the mobile mammography units included reached underserved women. Most of the women screened in mobile units were African American or Latina, low income, and/or uninsured. Mobile mammography users reported low adherence to 1-year (12%–34%) and 2-year (40%–48%) screening guidelines. Some difficulties faced by mobile clinics were patient retention, patient follow-up of abnormal or inconclusive findings, and women inaccurately perceiving their breast cancer risk.ConclusionMobile mammography clinics may be effective at reaching medically underserved women. Adding patient navigation to mobile mammography programs may promote attendance at mobile sites and increase follow-up adherence. Efforts to promote mammographic screening should target women from racial/ethnic minority groups, women from low-income households, and uninsured women. Future research is needed to understand how to best improve visits to mobile mammography clinics.

The Impact of COVID-19 on Cancer Screening: Challenges and Opportunities

“…Canceling or postponing cancer screenings may not equate to avoiding a cancer diagnosis but delayed cancer diagnoses could lead to increased mortality. On the contrary, the drastic decrease of cancer screenings in the United States and across the globe may have severe consequences, such as an unexpected rise in cancer incidence and later-stage cancer diagnosis, and in turn, more cancer deaths in patients [ 11 , 38 - 41 ]. While patients might be in great need for help during this crisis, assistance from health care practitioners was also interrupted due to the COVID-19 pandemic [ 42 ].…”

“…Some of the approaches to more universal access to cancer screening using traditional and organized outreach measures include local mammography vans for breast cancer [ 38 , 107 ], fecal immunochemical test (FIT) or other at-home stool tests for colon cancer detection [ 108 , 109 ], and cost-effective technology-based solutions such as social media campaigns [ 110 , 111 ], so that a broader population can be served and the widening cancer disparities can be alleviated. In the fight against inequalities, preventative measures such as cancer screening are more relevant to underserved populations than ever before.…”

Quantification of Potential Inequities in Breast Cancer Incidence in New Mexico Through Bayesian Disease Mapping

“…A third limitation of our study is that our data were based on a 10-year time period 2005-2014, which means these data were 6 years old at the time this article was written. Socioeconomic, cultural, and healthsystem barriers to mammography among AI/AN women have been identified over the last decade (18)(19)(20), and interventions are in development to reduce such barriers and increase satisfaction among AI/AN women with mammography (21). Furthermore, access to breast cancer screening for non-Hispanic AI/AN women and medically underserved populations in general has increased through outreach strategies such as mobile mammography and the use of lay health advisors (22)(23)(24).…”

Barriers to mammography screening in a riverine population of the Brazilian Amazon

“…The use of MPUs allows the detection of individuals with a better prognosis in regard to clinical diagnosis, as determined by smaller tumors at earlier stages 5 . After the identification of suspected or positive cases, the affected individuals should be directed to a diagnostic flow system, and this flow should be organized, especially in rural and low‐income populations 6 . Apparently, this study is the first to use river transport of a team in a breast cancer diagnosis project.…”