Dataset Information

Comparative Access to and Use of Digital Breast Tomosynthesis Screening by Women's Race/Ethnicity and Socioeconomic Status.

ABSTRACT:

Importance

Digital breast tomosynthesis (DBT) has reduced recall and increased cancer detection compared with digital mammography (DM), depending on women's age and breast density. Whether DBT screening access and use are equitable across groups of women based on race/ethnicity and socioeconomic characteristics is uncertain.

Objective

To determine women's access to and use of DBT screening based on race/ethnicity, educational attainment, and income.

Design, setting, and participants

This cross-sectional study included 92 geographically diverse imaging facilities across 5 US states, at which a total of 2?313?118 screening examinations were performed among women aged 40 to 89 years from January 1, 2011, to December 31, 2017. Data were analyzed from June 13, 2019, to August 18, 2020.

Exposures

Women's race/ethnicity, educational level, and community-level household income.

Main outcomes and measures

Access to DBT (on-site access) at time of screening by examination year and actual use of DBT vs DM screening by years since facility-level DBT adoption (?5 years).

Results

Among the 2?313?118 screening examinations included in the analysis, the proportion of women who had DBT access at the time of their screening appointment increased from 11 558 of 354 107 (3.3%) in 2011 to 194 842 of 235 972 (82.6%) in 2017. In 2012, compared with White women, Black (relative risk [RR],?0.05; 95% CI,?0.03-0.11), Asian American (RR,?0.28; 95% CI, 0.11-0.75), and Hispanic (RR,?0.38; 95% CI, 0.18-0.80) women had significantly less DBT access, and women with?less than a high school education had lower DBT access compared with college graduates (RR,?0.18; 95% CI,?0.10-0.32). Among women attending facilities with both DM and DBT available at the time of screening, Black women experienced lower DBT use compared with White women attending the same facility (RRs,?0.83 [95% CI, 0.82-0.85] to 0.98 [95% CI, 0.97-0.99]); women with lower educational level experienced lower DBT use (RRs,?0.79 [95% CI, 0.74-0.84] to 0.88 [95% CI, 0.85-0.91] for?non-high school graduates and 0.90 [95% CI, 0.89-0.92] to 0.96 [95% CI, 0.93-0.99] for high school graduates vs college graduates); and women within the lowest income quartile experienced lower DBT use vs women in the highest income quartile (RRs,?0.89 [95% CI, 0.87-0.91] to 0.99 [95% CI, 0.98-1.00]) regardless of the number of years after facility-level DBT adoption.

Conclusions and relevance

In this cross-sectional study, women of minority race/ethnicity and lower socioeconomic status experienced lower DBT access during the early adoption period and persistently lower DBT use when available over time. Future efforts should address racial/ethnic, educational, and financial barriers to DBT screening.

SUBMITTER: Lee CI

PROVIDER: S-EPMC7896194 | biostudies-literature | 2021 Feb

REPOSITORIES: biostudies-literature

ACCESS DATA

Publications

Comparative Access to and Use of Digital Breast Tomosynthesis Screening by Women's Race/Ethnicity and Socioeconomic Status.

Lee Christoph I CI Zhu Weiwei W Onega Tracy T Henderson Louise M LM Kerlikowske Karla K Sprague Brian L BL Rauscher Garth H GH O'Meara Ellen S ES Tosteson Anna N A ANA Haas Jennifer S JS diFlorio-Alexander Roberta R Kaplan Celia C Miglioretti Diana L DL

JAMA network open 20210201 2

<h4>Importance</h4>Digital breast tomosynthesis (DBT) has reduced recall and increased cancer detection compared with digital mammography (DM), depending on women's age and breast density. Whether DBT screening access and use are equitable across groups of women based on race/ethnicity and socioeconomic characteristics is uncertain.<h4>Objective</h4>To determine women's access to and use of DBT screening based on race/ethnicity, educational attainment, and income.<h4>Design, setting, and partici ...[more]

PMID: 33606032

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Dataset Information

Comparative Access to and Use of Digital Breast Tomosynthesis Screening by Women's Race/Ethnicity and Socioeconomic Status.

Importance

Objective

Design, setting, and participants

Exposures

Main outcomes and measures

Results

Conclusions and relevance

Publications

Comparative Access to and Use of Digital Breast Tomosynthesis Screening by Women's Race/Ethnicity and Socioeconomic Status.

Similar Datasets

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