Association of Population Screening for Breast Cancer Risk With Use of Mammography Among Women in Medically Underserved Racial and Ethnic Minority Groups

Abstract

IMPORTANCE Black women bear a disproportionate burden of breast cancer mortality in the US, in part due to inequities in the use of mammography. Population screening for breast cancer risk in primary care is a promising strategy for mitigating breast cancer disparities, but it is unknown whether this strategy would be associated with increased mammography rates in underserved women of racial and ethnic minority groups.OBJECTIVE To examine whether providing individualized breast cancer risk estimates is associated with an increase in the rate of screening mammography. DESIGN, SETTING, AND PARTICIPANTSA cohort study was conducted in women receiving individualized risk estimates as part of routine primary health care at federally qualified health centers in medically underserved communities in Chicago, Illinois. The study was conducted from

Patterns and predictors of adherence to breast cancer screening recommendations in Alberta’s Tomorrow Project

“…Despite adjusting for a broad set of confounders, the possibility of residual confounding related to unmeasured potential confounders, such as physician referral patterns and breast self-examinations, exists. For example, ethnic minority group has been reported to have low mammography uptake compared with other populations ( Raynault et al, 2020 , Schwartz et al, 2021 ). However, the ethnicity variable was removed due to the small ethnic minority population in ATP dataset, which cannot support a model-based analysis.…”

Practice-Changing Opportunity to Reduce Disparities in Screening Mammography—Implementation of Risk Assessment in Primary Care

“…Reducing health disparities in women of racial or ethnic minority groups is a public health priority. As highlighted by Schwartz et al, 6 implementation of individualized breast cancer risk assessment programs in primary care practice may increase mammogram rates among women who are Black or Hispanic who are identified as being at elevated risk for breast cancer. Incorporation of easily available validated risk assessments into a busy primary practice is a scalable population-level strategy that will help promote health equity and change clinical practice.…”

“…The prospective cohort study was conducted at federally qualified health centers in underserved, racial and ethnic minority communities. 6 Patients received their risk assessment from their primary care clinicians, and 52.1% were found to be at average risk and 47.9% at high risk for developing breast cancer. One hundred fourteen of the study participants self-identified as African American (60.6%), Hispanic (37.2%), and other racial and ethnic groups (2.1%).…”

“…Schwartz et al evaluated the feasibility of individualized breast cancer risk assessment in primary care practice as an intervention to increase mammography rate among Black and Hispanic women at increased breast cancer risk. A custom software application incorporating various validated risk assessment tools was implemented and risk factor data were entered by nonlicensed clinic staff at the annual well-visit.…”

Adapting a breast cancer early presentation intervention for Black women: A focus group study with women of Black African and Black Caribbean descent in the United Kingdom

“…Ethnic inequalities in breast cancer outcomes have been documented in many countries with multicultural populations (Brennan, 2017 ; Gathani, Chaudhry, et al, 2021 ; Schwartz et al, 2021 ), with Black women being particularly at higher risk of mortality. In the United Kingdom, despite breast cancer being less common in Black than White women, Black women (i.e., women of African descent including those women born on the African continent, in the Caribbean, and in the United Kingdom) are more likely to be diagnosed with advanced or metastatic breast cancer and die from the disease than their White counterparts (Jack et al, 2009 ; Jack et al, 2014 ; Januszewski et al, 2014 ).…”