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Black women, poor face barriers to breast cancer screening despite interventions
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Black women, women living in poverty, and women who expressed deep distrust of the health care system appeared less likely to report barriers to obtaining screening mammograms, according to findings published in Cancer.
Consequently, those women were less likely to receive subsequent screenings,
“Our findings suggest that black women and women living in poverty, who need patient navigation interventions the most, are in fact less likely to report their barriers to optimal care,” Sage Kim, PhD, assistant professor in the department of health policy and administration at University of Illinois at Chicago’s School of Public Health and University of Illinois Cancer Center, said in a press release. “Perhaps women who do not trust the health care system may not feel comfortable telling care providers about their barriers that could potentially affect the ways in which they engage in health care.”
Black women are more likely to be diagnosed with breast cancer at a later stage, in part due to barriers to timely screening mammography, according to study background. However, patient navigation that aims to overcome these barriers could reduce disparities in breast cancer screening and treatment.
Researchers pooled data from 3,754 women included in the randomized controlled Patient Navigation in Medically Underserved Areas study.
The study included women referred for a screening mammogram who had a history of benign screening results and received patient navigation intervention.
The intervention included access to patient navigators who assessed and helped address potential barriers to screening. Navigators maintained contacts with women until diagnostic resolution was achieved.
Nearly 14% of women who received the intervention identified one or more barriers to obtaining a follow-up screening mammogram. This led to additional interactions with navigators who helped overcome the barriers.
“Reporting barriers can in fact bring about additional support, which may result in better outcomes,” Kim and colleagues wrote.
However, researchers found that black women, women living in poverty, and women with a higher level of distrust of the health care system were less likely to report barriers to obtaining a follow-up screening mammogram.
Among black women, the probability of reporting barriers was 0.12 for those not living in poverty and 0.04 for those in poverty. Among white women, the probability was 0.08 for those not living in poverty and 0.5 for those in poverty. Among Hispanic women, the probability was 0.07 for those not in poverty and 0.25 for those in poverty.
“A way to improve the effectiveness of navigation would be to recognize how minority women’s gender images and expectations could shape how they seek help and support,” Kim and colleagues wrote. “A report of no barriers does not always translate into no problems. Proactive approaches to identify potential barriers may be beneficial.”– by Jennifer Southall
Reference:
Kim SJ, et al. Cancer. 2018;doi:10.1002/cncr.31636.
Disclosure: Kim reports no relevant financial disclosures. Please see the study for all other authors’ relevant financial disclosures.
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Kim SJ, et al. Cancer. 2018;doi:10.1002/cncr.31636.
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