Disparities in Breast Cancer Screening Lead to Poor Outcomes for Disadvantaged Americans

Breast cancer screening is essential to early diagnosis and treatment which can improve outcomes and significantly reduce mortality. The American Cancer Society (ACS) reports 67% of women aged 40 and older had a breast cancer screening in the past two years, but these rates vary across populations by race and ethnicity, age group, region, income level, and type of insurance.

This study expands on the ACS report by evaluating 7-year trends (2017-2023) in breast cancer screening rates across four major insurance types in the United States (traditional Medicare Fee-for-Service, Medicare Advantage, commercial, and Medicaid), using the lookback timeframe (27 months) and age range (50-74) as defined in the commonly used Breast Cancer Screening (BCS) quality measure utilized by the Centers for Medicare & Medicaid Services (CMS) in the Medicare Five-Star Rating program and other value-based payment programs.

Breast cancer screening rates are consistently lowest (40-55%) among women with Medicaid across income, education, English proficiency, and household composition. Across all payer types, the greatest disparities in breast cancer screening are by income. English proficiency, education, and living alone have a relatively small, but consistent, influence on breast cancer screening rates. Efforts should be made to explore barriers to breast cancer screening among women with Medicaid.