Trends in Breast Cancer Screening Between Medicare Beneficiaries With and Without Food Insecurity

Despite the importance of food insecurity, there remains limited data on recent trends in disparities between individuals with and without food insecurity in the receipt of breast cancer screening. The authors examined national trends in breast cancer screening rates between female Medicare beneficiaries with and without food insecurity as well as determined whether access to breast cancer screening was disrupted by the COVID-19 pandemic.

The authors performed repeated cross-sectional analyses on 2018-2021 data of Medicare Current Beneficiary Survey Public Use Files. Study sample included 4,459 (in 2018); 4,565 (in 2019); 4,334 (in 2020); and 3,966 (in 2021) noninstitutionalized female Medicare beneficiaries. After applying survey weights, this corresponds to 119,746,358 total beneficiary-years over the 2018-2021 period. The authors fitted a logistic regression model to assess the differences in the receipt of breast cancer screening between female Medicare beneficiaries with and without food insecurity over time.

The rate of breast cancer screening between female beneficiaries with and without food insecurity was not statistically different from 2018 to 2020. However, in 2021, female beneficiaries with food insecurity had a rate that was 8.1 percentage points (95% CI= -15.2, -1.0) lower than that of female beneficiaries without food insecurity.

These findings suggest the importance for identifying female Medicare beneficiaries who are at increased risk of food insecurity and missed breast cancer screening in clinical settings during and after the COVID-19 pandemic.