What’s Keeping Women From Getting Mammograms?

It’s not just cost. Social isolation, lack of transportation among top barriers to cancer screenings, new research shows

Rachel Nania,

AARP

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En español

Published April 10, 2024

mid-body shot of a woman in a surgical gown talking to a doctor in a white lab coat holding a clipboard

AARP; (Source: Getty Images)

About a quarter of women ages 50 to 74 are not up to date on routine mammograms despite pleas from doctors and public health experts that more middle-aged and older women get screened for breast cancer. A new study from federal researchers pinpoints several factors that are causing women to skip out on screenings — and it’s not just cost and access to health care.

Feeling socially isolated, experiencing food insecurity or job loss, or not having access to reliable transportation can affect mammogram participation, according to a study published April 9 from the Centers for Disease Control and Prevention (CDC). Another so-called health-related social need that keeps women from getting screened is a general dissatisfaction with life.

“If we are to achieve higher breast cancer screening for all women, we have to look at all the possible challenges women face in getting mammograms,” Lisa C. Richardson, M.D., director of the CDC’s Division of Cancer Prevention and Control, said in a news release.

Researchers analyzing data from the 2022 Behavioral Risk Factor Surveillance System found that the more health-related social needs a woman has, the less likely she is to get a mammogram. About 83 percent of women with no health-related social needs had received a mammogram in the previous two years, compared with about 66 percent of those with three or more health-related social needs. The cost of health care was the biggest barrier, the study found.

Courtesy: CDC

“The bottom line is, women are more likely to get lifesaving mammograms when their social needs are met,” Jacqueline Miller, M.D., medical director of the CDC’s National Breast and Cervical Cancer Early Detection Program, said in a news briefing.

Breast cancer, which can also be diagnosed in men, is the most common cancer among women in the U.S., and a 2024 report from the American Cancer Society shows its incidence is increasing. The disease claims more than 42,000 U.S. lives each year, and a disproportionate share of these deaths are among Black women. The median age of a breast cancer diagnosis in women is 63. However, screening with a mammogram — an X-ray picture of the breast — can reduce cancer deaths, research suggests. A Swedish study published in the journal Cancer found a 41 percent reduction in fatal breast cancers within 10 years of diagnosis among women who participated in mammography screenings.

New draft guidelines from the U.S. Preventive Services Task Force recommend that women start getting regular mammograms at 40, rather than 50, and continue with them every other year through age 74. Public comments on the draft recommendations end June 5, after which final guidelines will be issued.

Overcoming barriers

If any social factors are keeping you from getting screened for breast cancer, know this.

The Centers for Medicare and Medicaid Services this year implemented a new billing code that allows health care providers to be reimbursed for conducting a risk assessment for health-related social needs and connecting patients to services that can help. Questions in such an assessment might include whether a patient gets enough to eat or has access to transportation, the CDC’s chief medical officer, Debra Houry, M.D., explained in a news briefing. “Asking these questions is critically important. It really just takes a minute to focus on a couple of key questions to open that dialogue between a patient and a provider,” she said.

Medicare and most private insurance plans cover preventive screening mammograms at no out-of-pocket cost. What’s more, women who are uninsured or underinsured are eligible for free or low-cost breast cancer screenings through the National Breast and Cervical Cancer Early Detection Program.

“These programs are investments made by CDC and are available across the United States to state, tribal and territorial health departments,” Houry said. You can find a screening program near you on the CDC’s website.