Access to Breast Cancer Screening: Disparities and Determinants- Expert Panel Narrative Review.

Journal: AJR. American journal of roentgenology
Published Date:

Abstract

Although breast cancer screening reduces mortality, disparities in access continue to limit equitable care. Medically underserved groups-including individuals who are American Indian or Alaska Native, Black, Hispanic, disabled, and LGBTQ+-face significant barriers in accessing screening mammography services. This Expert Panel Narrative Review leverages the National Institute on Minority Health and Health Disparities Research Framework to analyze persistent inequities in screening, focusing on race, ethnicity, socioeconomic status, disabilities, health insurance, and geography. Screening guidelines vary across organizations, complicating access for underserved groups. Legislative efforts, including breast density notification laws and the Find It Early Act, aim to address disparities but remain insufficient. Traditional risk models can yield inconsistent assessments of high-risk status and disparities in appropriate referrals for genetic testing and supplemental screening. Emerging technologies like artificial intelligence promise to reduce these gaps by improving risk assessment and detection accuracy, although clinical integration requires careful evaluation to avoid exacerbating existing inequities. This article underscores the importance of policies and practices that address the needs of disabled individuals and other marginalized populations, focusing on creating inclusive and effective screening systems. Recommendations are provided to guide future research, policy development, and clinical practices aimed at mitigating disparities in breast cancer screening.

Authors

  • Soudabeh Fazeli
    Department of Radiology, Division of Breast Imaging, UC San Diego Health, 9400 Campus Point Dr, La Jolla, CA 92037.
  • Anand K Narayan
    Department of Radiology, University of Wisconsin-Madison, Madison, WI.
  • Victoria L Mango
    Memorial Sloan Kettering Cancer Center, Breast and Imaging Center, 300 E 66th St, Ste 715, New York, NY 10065.
  • Rifat Wahab
    Department of Radiology, Vanderbilt University Medical Center, Nashville, TN.
  • Tejas S Mehta
    Department of Radiology, UMass Memorial Medical Center/UMass Chan Medical School, Worcester, MA.
  • Haydee Ojeda-Fournier
    Department of Radiology, University of California, San Diego, 9500 Gilman Drive, La Jolla, CA, 92093, USA.

Keywords

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