Addressing disparities in 3D mammo access

by Gus Iversen, Editor in Chief | July 06, 2021
Women's Health
From the July 2021 issue of HealthCare Business News magazine

HCB News: What types of patients are poised to benefit the most from 3D mammography?
CL: We know from the Breast Cancer Surveillance Consortium that women obtaining a baseline mammogram, or first-ever mammogram, benefit the most from DBT over DM screening. We also know that women with the two middle types of breast density (scattered fibroglandular and heterogeneously dense breasts) have improved cancer detection with DBT. All women, regardless of breast density, likely benefit from DBT for decreases in false-positive recall rates.

HCB News: Can insurance play a role in leveling the playing field for access to 3D mammo?
CL: Our analysis demonstrated that women with lower income levels continue to experience disparities in DBT screening use, even years after facility-level DBT adoption. This suggests that copays and insurance play an important role in enabling access to care. Washington state has taken the legislative step to mandate that DBT screening be offered to all women without copay. This has allowed Washington to ensure DBT access for everyone regardless of insurance status.

HCB News: Do you think public health initiatives and media campaigns could help raise awareness of 3D mammo?
CL: We definitely want to improve health literacy around risk-based breast cancer screening. We need to do a better job of informing women about their own risk factors and what screening regimen would work best for them. It's not one-size-fits-all.

HCB News: Are these findings surprising or do they reflect a bigger picture of medical care access in the U.S.?
CL: These findings are, unfortunately, not surprising. Traditionally underserved populations are usually the last to benefit from any new medical technology. DBT screening is no different. It's important for radiology practices and policy makers to be cognizant of these DBT screening access and use differences, and future efforts should address racial/ethnic, educational, financial, and geographic barriers to obtaining DBT screening.

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