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  • Author
    Erin Collier
  • Co-author

    Christine Dauphine MD, FACS

  • Title

    Identifying Barriers to Screening Mammography among Underserved Women in Los Angeles

  • Abstract


    Breast cancer is the most commonly diagnosed non-cutaneous cancer among women in the United States. Mortality rates show that Black women are much more likely to die of breast cancer than any other ethnicity. Moreover, additional factors, such as poverty, lack of health insurance and less education, common amongst lower socioeconomic groups, are associated with reduced rates of breast cancer survival. Given the lower survival among certain racial/ethnic groups and the association with lower socioeconomic status, it is important to maintain adequate breast cancer screening within these populations.


    To identify barriers to screening mammography in minority women of underserved populations of Los Angeles County.


    A sample of women from various lower socioeconomic communities within Los Angeles County was selected for this is a cross-sectional study. Women over the age of 40-years-old were included and asked to complete a 40-item questionnaire with Likert scale questions using variables from the Health Belief Model to identify perceived barriers to screening mammography.


    There was a total of 57 respondents. The majority of participants were Latino (70.2%), followed by Black (28.1%). The majority of participants had medical insurance (62.5%) and a primary care provider (58.9%). Over 84% of respondents reported having ever had a mammogram with over 64% having had a mammogram at least every two years. Fifty-four percent of participants felt that there was a low chance of them ever getting breast cancer in their lifetime, 91% felt that there would be a high chance of them scheduling a mammogram if there were evening and weekend times available, and 38% felt that there would be a low chance of them finding a way to pay for a mammogram. Ninety-five percent of respondents felt that they would be more likely to get a mammogram if their provider recommended it.


    Our study provides insight into the barriers that women of lower socioeconomic status in Los Angeles face in adhering to screening mammography guidelines. Though a high proportion of the sample reported having received a mammogram on a regular basis, 35% of women did not adhere to mammography guidelines of screening at least every 2 years and 16% of respondents reported never having a mammogram.  Low perception of lifetime breast cancer susceptibility, hours of operation at mammography centers, and cost were the greatest perceived barriers for our cohort. Physician recommendation was highly important to receiving screening mammography in this sample. Our findings suggest interventions to reduce barriers related to time and cost may have some benefit. 

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