Sociodemographic Determinants in Breast Cancer Screening among Uninsured Women of West Texas

Abstract

Background and Objectives: Early detection through appropriate screening is key to curing breast cancer. The Access to Breast Care for West Texas (ABC4WT) program offers no-cost mammography to underserved women in West Texas. The U.S. Preventative Task Force (USPSTF) guidelines are breast cancer screening guidelines which suggest screening for all women at the age of 50 years. The focus of this study was to identify sociodemographic barriers and determinants for breast cancer screenings, as well as screening outcomes, in low income, uninsured, or under-insured communities in West Texas. Materials and Methods: The ABC4WT program’s patient database was queried from 1 November, 2018, to 1 June, 2021, for sociodemographic variables, screening history, and results to identify high-risk groups for outreach. The American College of Radiology’s risk assessment and quality assurance tool, BI-RADS (Breast Imaging-Reporting and Data System), a widely accepted lexicon and reporting schema for breast imaging, was used for risk differentiation. Results: The cancer rate for ABC4WT’s program was significantly higher than the national mean (5.1), at 23.04 per 1000 mammograms. Of the 1519 mammograms performed, women between 40 and 49 years old represented the highest percentages of BI-RADS 4 and 5 (42.0% and 28.0%, respectively; p = 0.049). This age group also received 43.7% of biopsies performed and comprised 28.6% (n = 10) of cancers diagnosed (n = 35) (p = 0.031). Additionally, participants with a monthly household income of less than USD 800/month/person were more likely to result in a cancer diagnosis (70.6%) than higher incomes (29.4%) (p = 0.021). Conclusions: These determinants most starkly impacted women 40–49 years old who would not have been screened by U.S. Preventative Services Task Force (USPSTF) guidelines. This population with increased cancer risk should be encouraged to undergo screening for breast cancer via mammography.

Social determinants of health and health inequities in breast cancer screening: a scoping review

“…Ethnic minority women, with the exception of those identifying as Asian, had a lower likelihood of being screened, and Black women experienced a higher risk of diagnosis upon first screening (25)(26)(27)(28)(29). While few studies analyze the effect of sexual orientation on breast cancer screening, initial insights reveal there are significant differences in mammography between bisexual, lesbian, and heterosexual women regardless of racial/ethnic groups (30). In considering religious values, fatalism-emphasizing religions were associated with less screening adherences and maintenance of modesty did not prove a significant limitation for women receiving mammograms (31)(32)(33).…”

Recent Advances in Breast Cancer Diagnosis, Treatment, Psychology, Management, and Reconstruction

“…It is well known that the socioeconomic status of all cancer patients contributes to the availability of care and time of diagnosis, with many of these patients less likely to have the resources for regular screening. The study provided by Jensen et al [ 3 ] examined a population in West Texas and suggested considering earlier screening for breast cancer in this population, as well as for others with similar sociodemographic determinants. The study by Kazlauskiene et al [ 4 ] further emphasized the importance of paying attention to the psychological aspect of breast cancer and how this diagnosis may increase suicidal ideation.…”