Sister, Give Me Your Hand: a Qualitative Focus Group Study on Beliefs and Barriers to Mammography Screening in Black Women During the COVID-19 Era

Abstract

Aims/Purpose To evaluate current day challenges and beliefs about breast cancer screening for Black women in two diverse northeast communities in the midst of the COVID-19 pandemic. Background Breast cancer is the second leading cause of cancer-related death in women in the USA. Although Black women are less likely to be diagnosed with breast cancer, they suffer a higher mortality. Early detection of breast cancer can be accomplished through routine screening mammography, yet the effect of the COVID-19 pandemic on mammography screening barriers and perception in minority communities is uncertain. Methods Five focus group interviews were conducted as the first phase of a mixed method study across two heterogeneously diverse locations, Camden, New Jersey, and Brooklyn, New York. Results Thirty-three women participated in this study; sixteen women were recruited at the New Jersey location and seventeen at the New York location. Only two thirds of the women stated that they had received a mammogram within the last 2 years. The major themes were binary: I get screened or I do not get screened. Subthemes were categorized as patient related or system related. Conclusions Our findings on factors that affect breast cancer screening decisions during the COVID-19 era include barriers that are related to poverty and insurance status, as well as those that are related to medical mistrust and negative healthcare experiences. Community outreach efforts should concentrate on building trust, providing equitable digital access, and skillfully addressing breast health perceptions.

Mammography screening beliefs and barriers through the lens of Black women during the COVID‐19 pandemic

“…Mammography is known to be an effective screening tool leading to decreased breast cancer mortality, yet minority women continue to experience barriers that affect the utilization of this powerful early detection tool. 6,20,31 For Black women, decreased access to mammography screening often involves multiple factors, including personal and systemic barriers to care. 7 This study focused on understanding unique barriers to mammography screening for Black women in two communities in Camden, New Jersey, and Brooklyn, New York, during the early years of the COVID-19 pandemic.…”

“…Routine mammography screening remains the best method for detecting breast cancer at its earliest stage and improves survival, yet systemic and patient‐related barriers to screening exist for Black women. These barriers include access to quality screening facilities, provider underreferral, insurance constraints, and mammography screening perceptions 5–8 . Recognizing the importance of early screening and diagnosis of breast cancer for Black women, national organizations such as the American Society of Breast Surgeons (ASBRS), the American College of Radiology (ACR), and the Society of Breast Imagers (SBI) as well as national and international experts in breast cancer disparities recommend that women with an average risk of breast cancer start annual screening for breast cancer at the age of 40 years 8–10 …”

“…These barriers include access to quality screening facilities, provider underreferral, insurance constraints, and mammography screening perceptions. [5][6][7][8] Recognizing the importance of early screening and diagnosis of breast cancer for Black women, national organizations such as the American Society of Breast Surgeons (ASBRS), the American College of Radiology (ACR), and the Society of Breast Imagers (SBI) as well as national and international experts in breast cancer disparities recommend that women with an average risk of breast cancer start annual screening for breast cancer at the age of 40 years. [8][9][10] In March 2020, the coronavirus disease 2019 (COVID- 19) pandemic emerged.…”

“…Because of the importance of mammography screening for early diagnosis, there is concern that there will be a widened gap in breast cancer disparities for Black women. 6,17,18 The purpose of this study was to evaluate breast cancer mammography screening habits and barriers in Black women in two northeast communities amid the COVID-19 pandemic. We explored mammography screening behaviors, perceptions of mammograms, and the psychosocial factors of spirituality, faith, racial discrimination, and coronavirus-associated anxiety in 256 Black women during the COVID-19 pandemic.…”

Examining Associations between Source of Cancer Information and Mammography Behavior among Black Church-Going Women

“…In a 2018 study that included 50 in-depth interviews with Black and White women, Padamsee et al concluded that Black women were less aware of their breast cancer prevention options due to structural, social, and interpersonal barriers in accessing such information [ 102 ]. Additionally, in a series of focus groups conducted in December 2020 and January 2021 with 33 women (28 identifying ad Black, 4 as Afro-Caribbean, and 1 as Afro-Latina) in New York and New Jersey, Bea et al found that several participants expressed skepticism or misunderstanding of mammograms, including the belief that the mammogram itself puts a patient at risk of getting breast cancer [ 103 ]. Thus, although additional studies with more recent data would be helpful to better understand changes in associations between the internet/social media as a cancer information source and mammography uptake over the last decade, the context of increased internet use coupled with a persistent lack of representation or race-tailored screening guidelines for Black women may suggest the continuing relevance of the current findings.…”