Social Drivers of Guideline-Discordant Breast Cancer Screening by Age and Mortality Risk

Area of Science:

• Public Health
• Oncology
• Health Disparities

Background:

• Understanding social determinants of mammography screening is crucial for optimizing breast cancer (BC) screening guidelines.
• Guidelines aim to maximize benefits and minimize harms across diverse populations.
• Examining racial/ethnic, socioeconomic, and geographic patterns in guideline-discordant screening is essential.

Purpose of the Study:

• To analyze patterns of mammography underscreening and overscreening.
• To investigate these patterns across different racial/ethnic groups, socioeconomic statuses, and geographic locations.
• To inform equitable breast cancer screening delivery strategies.

Main Methods:

• Utilized 2022 Behavioral Risk Factor Surveillance System data.
• Defined screening participation based on major screening guidelines.
• Employed modified Poisson regression to assess screening by race/ethnicity, healthcare access, and socioeconomic factors.

Main Results:

• Non-Hispanic American Indian/Alaskan Native and unknown race women aged 50-74 were less likely to be screened compared to non-Hispanic White women.
• Non-Hispanic Black women showed higher rates of screening (underscreening and overscreening) across various age and risk groups.
• Screening participation was consistently lower among women with limited socioeconomic resources.

Conclusions:

• Social drivers significantly influence both underscreening and overscreening in mammography.
• Equitable delivery of breast cancer screening requires targeted implementation and de-implementation efforts.
• Addressing socioeconomic disparities is key to optimizing screening outcomes.