The groups with the highest percentage of responses indicating they would skip additional imaging were Hispanic (33.0%), high school educated or less (31.0%), household income less than $35,000 (27.0%) and Medicaid/uninsured (31.5%).

“Prior research has shown that these groups tend to already have lower adherence to preventative services, including breast cancer screening, and tend to have worse breast cancer outcomes,” Dr. Ngo said. “Based on these results, these out-of-pocket payments may account for at least a part of the delay in seeking care. This, in turn, leads to delays in breast cancer diagnosis and treatment, increases overall breast cancer mortality and exacerbates existing gaps in breast cancer care in women who already have financial barriers in care.”


The survey also asked whether respondents would forgo the initial screening mammography exam if they knew they would have to pay a deductible for follow-up tests. Of 707 respondents, 129 (18.3%) said they would skip the screening mammography exam, 465 (65.8%) would not skip mammography, and 113 (16.0%) were undecided.

Identifying socioeconomic barriers to health care is critical in addressing existing disparities and ensuring better outcomes for vulnerable patient populations. The researchers hope that these findings will be useful in efforts to remove financial barriers to care.

“We hope these results can be used to advocate for legislation to eliminate out-of-pocket expenditure for screening diagnostic imaging follow-up to alleviate the existing healthcare disparities,” Dr. Ngo said.

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