Progress has been made in some U.S. regions in boosting adherence rates for cancer screening exams like mammography, but clusters of regional variation remain. That’s according to a new study in JAMA Network Open that offers hope for reducing access disparities in disadvantaged areas.
Disparities in healthcare access remain one of the nagging problems in the U.S. healthcare system.
- Previous studies have shown that racial background, socioeconomic status, and geographic location can all affect access to care, and ultimately, patient outcomes.
Nowhere is this more apparent than in cancer screening, where getting patients in for their exams has always been a challenge.
- Screening compliance rates (as of 2021) were approximately 76% for breast cancer, 75% for cervical cancer, and 72% for colorectal cancer.
But how does geography affect screening rates, and has progress been made over time?
- To answer these questions, researchers analyzed geographic variations in rates for the three major cancer screening tests (breast, cervical, and colorectal) over a 22-year period.
Screening data were analyzed at the county level from 1997 to 2019, with screening prevalence estimated over 3-5-year periods. For mammography screening, authors found…
- Screening rates were highest in the Northeast (Maine, New Hampshire, Vermont, and Massachusetts).
- Rates were lowest in the Southwest (Texas, New Mexico, and Arizona).
- Geographic areas that shifted from low to high uptake had lower socioeconomic status and more non-White residents, suggesting the success of efforts to improve screening in disadvantaged areas.
- Counties that did not improve had lower socioeconomic status than counties that maintained high screening rates.
- Rural areas had persistently low screening rates, reflecting lack of access to facilities as well as transportation.
The Takeaway
The new study on geographic variation in cancer screening rates offers encouraging news that – at least in some disadvantaged areas – improving screening uptake is possible. But more research is needed to find out why some areas fail to see improvement.
