WSU researchers found racial and socio-economic inequality in a pandemic mammogram screening

Spokane, Washington — A new study shows that the number of screening mammograms for women living in Washington plummeted by nearly half during a pandemic. The study determined that the largest decline was between colored women and women living in rural areas.

“Early detection of breast cancer dramatically increases the chances of successful treatment,” said lead research author Ofel Amram. “Our findings need to double efforts by healthcare providers to maintain preventive services and reach out to those underserved people who face significant health inequalities even before the pandemic. It suggests that there is. “

The study was conducted in partnership with MultiCare by researchers at Washington State University Health Sciences Spokane. MultiCare is a non-profit healthcare system covering 230 clinics and 8 hospitals throughout Washington.

The number of screening mammograms completed in Washington State decreased from 55,678 in 2019 to 27,522 in 2020, a decrease of 49%. Researchers also analyzed the data by race and observed a significant reduction in non-white women.

Breast cancer screening decreased by 64% for Hispanic women and 61% for Native American and Alaska Native women.

Researchers also looked at geographic locations and found that screening for rural women was reduced by almost 59%, while the number of completed mammograms for women in cities was reduced by about 50%.

The research team then analyzed the data by type of insurance, and women using Medicaid or out-of-pocket for treatment took advantage of commercial or government-run health insurance plans. We found that the reduction in screening was greater than in women who were.

The research team found that after the World Health Organization declared COVID-19 a global epidemic in March 2020, MultiCare patients completed screening mammograms from April to December 2019 and in the same month of 2020. I used medical record data.

“We know that the COVID-19 virus had disproportionate effects on certain populations, including racial and ethnic minority groups,” said the senior author of the study. “Our study added that some of the secondary effects of the COVID-19 pandemic also have a disproportionate effect on those populations. It is a double pain.”

Previous studies examined cancer screenings that were missed during the pandemic, but Monsivice said the study was the first to investigate racial and socio-economic differences. The research team’s goal is to remove barriers to cancer screening, which helps reduce cancer-related health inequalities.

Follow-up studies that identify social and economic factors that impede access to cancer screening during a pandemic are the next step for the research team. In addition to breast cancer, follow-up studies also look at missing colon and lung cancer screenings in both men and women.

Factors that may have helped reduce cancer screening include unemployment, loss of employer-provided health insurance, and caregiver stress due to school and day care closures or other situations. Another factor may be the fear of being infected with COVID-19, and the study’s co-author, Oncology of this project with the Multicare Cancer and Hematology Center in Spokane, Washington. Said Jeanne Robison, a nurse practitioner and principal investigator.

“One of the things we saw last year was that women who were pretty good at keeping up with screening were afraid to enter even after the medical facility was opened for regular screening. That’s what Robison said. “But even if the protocol to safely provide breast cancer screening was in place, there were still perceived risks and we had to tell some patients to come to the hospital.”

A decrease in primary care visits during the pandemic may also be a factor, she said. Primary care providers often play an important role in reminding women of the timing and importance of breast cancer screening.

Although the pandemic has increased virtual access to primary care advisors, there may be barriers to providing virtual care that can disproportionately affect a particular group of people. It is intended for researchers to analyze in follow-up.

In addition to Amram, Monsivais, and Robison, the authors of this treatise included Solmaz Amiri and John Roll of WSU Elson S. Floyd College of Medicine and Bethann Pflugeisen of the MultiCare Institute for Research & Innovation.

This study was supported by a grant from the Andy Hill Cancer Research Endowment Fund.

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