A new US Centers for Disease Control and Prevention study found that the more health-related social needs a woman has - like being food insecure or not being able to afford health care - the less likely she is to get a mammogram, the recommended screening for breast cancer. Cost was the biggest barrier, the study found.
The study, released on Tuesday, analyzed data from the 2022 Behavioral Risk Factor Surveillance system, an annual health survey of adults in the United States. Researchers found that recommended mammogram use was almost 20% lower among women ages 50 to 74 who had three or more health-related social needs in comparison with women who did not have any health-related social needs.
Health-related social needs are social conditions that adversely affect a person’s health. These types of social needs, such as feeling socially isolated, life dissatisfaction, lost or reduced employment hours, lack of reliable transportation and cost as a barrier to accessing health care were associated with not having a mammogram within the last two years, according to the study.
Cost of accessing health care was found to be the biggest barrier to getting a mammogram.
“We have to address these health-related social needs to help women get the mammograms they need,” Dr. Debra Houry, chief medical officer at the CDC, said in a news release. “Identifying these challenges and coordinating efforts between health care, social services, community organizations, and public health to help address these needs could improve efforts to increase breast cancer screening and ultimately save these tragic losses to families.”
Breast cancer causes more than 40,000 deaths in women each year in the United States, according to the CDC. And although breast cancer rates have been decreasing, the reduction has not been equally distributed among all populations. Research shows that Black women and women of lower socioeconomic status are more likely to die from breast cancer.
A mammogram is an X-ray picture of the breast that doctors use to look for early signs of breast cancer, according to the CDC. The earlier breast cancer is caught, the easier it is to treat, according to the National Breast Cancer Foundation. Routine screening mammograms have been shown to reduce breast cancer deaths by 22%, Houry said in a news conference.
The US Preventive Services Task Force currently recommends that women ages 50 to 74 get a screening mammogram every two years and that women ages 40 to 49 talk to their health-care providers about when to start and how often to get a mammogram.
The study found that 83% of women age 50 to 74 without any health-related social needs got a mammogram within the past two years, whereas only 66% of women in that same age group with three or more health-related social needs got a mammogram.
There were also state-level differences, ranging from 86% of women age 50 to 74 getting recommended mammograms in Rhode Island to only 64% of women in Wyoming, according to the study.
Black women had higher rates of mammogram use, but the reasons behind this cannot be discerned from the data, Dr. Jacqueline Miller, medical director of the CDC’s National Breast and Cervical Cancer Early Detection Program and lead author of the study said in a news conference.
Mammogram use is the lowest among women with low income, without health insurance and those who do not have a regular source of health care, according to the study. However, these new findings show that other health-related social needs also play a role, Miller said.
“The bottom line is, women are more likely to get lifesaving mammograms when their social needs are met,” Miller said in the news conference.
The Centers for Medicare and Medicaid Services implemented a new billing code this year that allows health-care providers to be reimbursed for administering an assessment to identify and document the patient’s health-related social needs. Houry said that these risk assessments should become a routine part of patient intake.
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“Health care providers can now assess whether women have health-related social needs and help women get the services they need. Every woman should be able to get screened for breast cancer without barriers,” Dr. Lisa C. Richardson, director of the CDC’s Division of Cancer Prevention and Control, said in a news release.
Mammograms are available at no cost to the patient through most private health insurance plans and Medicare, according to the news release. People with low incomes who do not have insurance can access free or low-cost breast and cervical cancer screening services through the CDC’s National Breast and Cervical Cancer Early Detection Program.
“Encourage and support all women in your life, at home, at work and in your community to get mammograms,” Houry said. “Do not put this off. There are services available to help.”