By Amy Norton
health day reporter
MONDAY, Dec. 19, 2022 (HealthDay News) — Many American women have to travel long distances to get to the nearest mammogram center, according to a new study — raising the question of whether this prevents some from getting a breast cancer screening.
Researchers found that 8.2 million women had limited access to mammography screening in 2022 – defined as living more than 20 minutes by car from the nearest facility. This figure was 7.5 million in 2006.
Unsurprisingly, women in rural areas were most affected: in rural areas of 28 states, more than half of women had limited access to mammography due to where they lived.
Although 20 minutes doesn’t seem like a long drive, it was the minimum. In some places, it was closer to 45 minutes to an hour, according to researcher Daniel Wiese, principal investigator at the American Cancer Society.
“That may not be the biggest barrier to mammography screening,” Wiese said. But, he added, it could be substantial for some women — especially if they have other barriers, like no paid time off or needing to find childcare.
What’s not clear from the study, however, is whether the long driving times actually affected testing rates in these rural areas.
Wiese’s team found that in many sparsely populated states, relatively fewer women were up to date on breast cancer screening, compared to more densely populated states. But it is unclear whether this is because women in rural areas had longer travel times to get tested.
Other experts said it was easy to see how long travel times could keep some women from getting tested. It is not a one-time event, but repeated every one to two years. And if there’s a suspicious find, that means a round trip.
“This is 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 was good to see research highlighting a health care disparity that can be overlooked: Americans in rural parts of the country often live far from a range of health care services.
“And mammography is no exception,” Guthrie said.
The conclusions, published on December 14 in the Journal of the National Cancer Institute, are based on data from the United States Food and Drug Administration. Researchers looked at the locations of mammography facilities in census tracts nationwide for the years 2006 to 2022, estimating the number of women aged 45 to 84 who would have limited access to mammography based on their place of residence.
During those years, the study found that between 12% and 13% of American women belonged to this group. But there were strong differences between rural and urban areas.
Across all rural census tracts, just over half of women drove more than 20 minutes to a mammography center in 2022. This compared to just 3% of women living in urban areas.
The findings raise important questions, said Dr. Laurie Zephyrin, senior vice president of health equity advocacy at the nonprofit Commonwealth Fund in New York.
“How does this affect testing rates or follow-up care? How does this affect breast cancer mortality? said Zephyrine.
A simple solution would be to open more mammography facilities in rural America. But there are few financial incentives to do so in sparsely populated areas, and it would buck the current trend of consolidating 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 consolidation of facilities into larger centers could be one explanation,” Wiese said.
However, having a mammography center nearby isn’t the only consideration, Guthrie and Zephyrin said: Women should also have access to high-quality care, including 3D digital mammography and experienced radiologists interpreting the images.
A longer trip to a larger medical facility, Zephyrin noted, could provide that.
There are other potential ways to help women in rural areas. Guthrie pointed to a New York State law that, among other things, required more than 200 hospitals and outreach clinics to offer evening, early morning, or weekend mammography services to help women who can’t get there during the working day.
Mobile testing units are another possible way to help, the three experts said. But again, Zephyrin stressed, it’s critical to ensure women receive good overall care — including any follow-up needed after a screening.
Guthrie said women who need help finding local resources, including free or low-cost mammograms, can call the Komen’s Breast Care hotline at 1-877 GO KOMEN.
Susan G. Komen has more on mammography screening.
SOURCES: Daniel Wiese, PhD, principal investigator, 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, Promoting Health Equity, Commonwealth Fund, New York; Journal of the National Cancer Institute, December 14, 2022