Many US women have to travel far to get a mammogram

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By Amy Norton

health day reporter

MONDAY, December 19, 2022 (HealthDay News) — Many American women have to travel long distances to get to the nearest mammography center, a new study finds — raising the question of whether this is deterring some from undergoing breast cancer screening.

Researchers found that in 2022, 8.2 million women would have limited access to mammography screening — defined as being more than a 20-minute drive from the nearest facility. That was an increase from 7.5 million in 2006.

Unsurprisingly, women in rural areas were hit hardest: In rural regions across 28 states, more than half of women had limited access to mammography because of where they lived.

20 minutes might not sound like a long drive, but that was the minimum. In some places, it was closer to 45 minutes to an hour, according to researcher Daniel Wiese, a senior scientist at the American Cancer Society.

“This may not be the biggest obstacle to mammography screening,” Wiese said. But, he added, it could be significant for some women — especially if they face other obstacles, like not having paid time off from work or the need to find childcare.

However, the study does not indicate whether long driving times actually affected screening rates in these rural areas.

Wiese’s team found that in many sparsely populated states, relatively fewer women were up to date about breast cancer screening than in more densely populated states. However, it is not known if this is because women in rural areas had to travel longer to get screened.

Other experts said it’s easy to see how long travel times could discourage some women from getting screened. It’s not a one-time event, it repeats itself every one to two years. And if there’s a suspicious finding, that means a return trip.

“It’s something that’s been on our radar for a long time,” said Molly Guthrie, vice president of policy and advocacy for breast cancer nonprofit Susan G. Komen.

She said it’s good to see that the research is highlighting a health care inequality that can be overlooked: Americans in rural parts of the country often live far from a range of health services.

“And mammography is no exception,” Guthrie said.

The results, published December 14 in the Journal of the National Cancer Institute, based on US Food and Drug Administration data. The researchers examined the locations of mammography facilities within census tracts nationwide for the years 2006 through 2022 and estimated the number of women ages 45 to 84 who would have limited access to mammography based on where they lived.

During those years, the study found, between 12% and 13% of US women fell into this group. But there were big differences between rural and urban areas.

Across all rural census counties in 2022, just over half of women traveled more than 20 minutes to a mammography center. In comparison, only 3% of women lived in urban districts.

The results raise important questions, said Dr. Laurie Zephyrin, Senior Vice President of Advancing Health Equity at the nonprofit Commonwealth Fund in New York City.

“How does this affect screening rates or follow-up? How does this affect breast cancer mortality?” said Zephyrin.

A simple-sounding solution would be to open more mammography facilities in rural America. But there is little financial incentive to do so in sparsely populated areas, and it would go against the current trend to consolidate health services into larger, regional medical centers.

Wiese’s team found that in 34 states, the proportion of women in rural areas with limited access to mammography increased over time.

“We think the merging of facilities into larger centers could be one explanation,” Wiese said.

However, having a mammography facility nearby isn’t the only consideration, Guthrie and Zephyrin said: Women should also have access to quality care — including 3-D digital mammography and experienced radiologists to interpret the images.

A longer drive to a major medical center, Zephyrin noted, might do the trick.

There are other ways to help women in rural areas. Guthrie pointed to a New York state law that, among other things, requires over 200 hospitals and counseling clinics to offer mammography services in the evening, early morning, or weekends to help women who can’t get there during the workday.

Mobile screening units are another possible way to help, all three experts said. But again, Zephyrin stressed, it’s crucial to make sure women get good overall care — including the follow-up care that’s needed after a screening.

Guthrie said women who need help finding local resources, including free or low-cost mammograms, can call Komen’s Breast Care Helpline at 1-877 GO KOMEN.

More information

Susan G. Komen has more on mammography screening.

SOURCES: Daniel Wiese, PhD, Senior Scientist, Cancer Disparity Research, American Cancer Society, Kennesaw, Georgia; Molly Guthrie, Vice President, Policy and Advocacy, Susan G. Komen, Dallas; Laurie Zephyrin, MD, MPH, MBA, Senior Vice President, Advancement of Equality in Health, Commonwealth Fund, New York City; Journal of the National Cancer Institute, December 14, 2022


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Many US women have to travel far to get a mammogram
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