Underserved Populations

There are major barriers to providing screening mammography services to women in underserved communities (Ref. 1).  As a result, women in these communities are at a much greater risk of having locally advanced breast cancer at the time of diagnosis as compared to women in the general population (Ref. 2). A major barrier to early detection in these communities are the costs associated with mammographic screening.

Progress is being made in addressing the cost of screening mammography.  The Affordable Care Act requires insurance companies including Medical to cover the costs of a screening mammogram (Ref. 3-4). However, insurance companies are not required to pay for a breast biopsy if the mammogram is abnormal.  There are non-profit organizations such as the Komen Foundation and the American Cancer Society that can help with funding (Ref. 5-6). There are also limited resources available for women with no insurance, but these resources are underutilized in underserved communities.  As a result, women in underserved communities continue to have high rates of locally advanced breast cancers (Ref. 7).

The second major barrier to early detection is the lack of appropriate educational services.  For education programs to succeed they must be culturally competent (Ref. 8). An example of a culturally competent educational program is the use of Promotores to educate women on the lifesaving value of screening mammography.  The Promotores are Hispanic women who have been trained to educate women in underserved communities about the lifesaving value of screening mammography. The Promotores go door-to-door in Hispanic communities to motivate women to participate in early detection efforts.

Additionally, the Promotores can schedule a screening mammogram to be performed in the local community.  This can be accomplished by utilizing mobile mammography services.  Studies have demonstrated that having mammogram performed in the local community increases rates of participation (Ref. 9-11).

Lessons learned in Hispanic communities can be applied to other underserved communities.  To succeed, programs for the underserved must be culturally competent. Education services must be provided by members from the local community and mobile mammography should be provided to improve access to screening. There is an urgent need to expand mobile mammography screening programs to underserved black communities who

have very low rates of mammographic screening and have high breast cancer mortality rates.

(Ref. 12-15).

We are excited to announce our newest program, Rolling with Hope-Mobile Mammography for the Underserved. We will have the ability to provide mammography to local communities by sending an innovative mobile coach with a radiologist and support staff to local health fairs and events.

The Rolling with Hope program is made possible by a generous Hologic grant and a partnership with RadNet Radiology/Imaging who believe in our mission to spread breast cancer education and basic screening mammography to our most needed populations. Our goal is to provide multiple screening events within each community. Ideally in 2023, we would like to bring Maddy the Mobile Mammogram Coach to multiple locations; and provide mammography’s for individuals who would not normally have easy access because of financial, insurance, or other barriers.

 

In conclusion, we believe that investing in strategies to improve rates of early detection in underserved populations will initially be costly, but overtime there will be a reduction in costs as the utilization of screening services are expanded (Screening Mammography: Cost & Benefits).  The cost reduction will also be associated with a reduction in breast cancer mortality rates as well as a reduction in the emotional costs associated with being diagnosed with an advanced breast cancer (Emotional Costs).