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Disparities in screening mammography utilization among Hispanic women in rural Texas from 2002 to 2018

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Abstract

Purpose

To examine the trends of racial/ethnic and urban–rural disparities in screening mammography use with a focus on Hispanic women in rural Texas, as well as to further investigate barriers to mammography screening practices.

Methods

A serial cross-sectional study was conducted on screening mammography including eligible female respondents (≥ 40 years) from the Texas Behavioral Risk Factor Surveillance System survey from 2002 to 2018.

Findings

Weighted descriptive analyses showed persistent racial/ethnic and urban–rural disparities in mammography screening rates among eligible women (≥ 40 years) in Texas. Overall, the mammography screening rates for women in rural areas were significantly lower than women in urban areas with a mean rate of 64.09% versus 70.89% (p < 0.001). Rural Hispanic women had the lowest mean mammography screening rate (55.98%) among all eligible women which is 16.27% below the mean mammography screening rate of non-Hispanic white women in urban areas. Weighted logistic regression model revealed that women with no health insurance or primary care providers were 52% (95% Confidence Interval [CI] 0.36–0.63, p < 0.001) or 54% (95% CI 0.35–0.6, p < 0.001) less likely having an up-to-date mammography screening compared with women with health insurance or primary care providers, respectively.

Conclusions

Our study demonstrated significant and persistent racial and urban–rural disparities in screening mammography utilization among Hispanic women compared with non-Hispanic white women from 2002 to 2018. Healthcare access is a major contributor to these disparities. It highlights the need for wide-scale interventions from public health and policymakers targeting under screened racial minorities and rural regions population to promote screening mammography services among disadvantaged population.

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Data availability

Data are publicly available upon request from Texas Health and Human Services. Here is the link for data request: https://www.dshs.texas.gov/texas-behavioral-risk-factor-surveillance-system-brfss.

Code availability

Code is available upon request from the authors.

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Acknowledgements

Thanks to Dr. Elizabeth Merwin for discussion and proofreading of the article. The authors also thank Texas Health and Human Services for providing the Texas BRFSS data for this study.

Funding

This work was supported by Data Management and Analysis Core for Comparative Effectiveness Research on Cancer in Texas (Grant No. RP 210130) funded by Cancer Prevention and Research Institute (CPRIT) of Texas. S.G. reports funding from Komen SAC150061, CPRIT RP160674, CPRIT RP210140, and National Cancer Institute P30 CA016672.

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Authors and Affiliations

  1. College of Nursing and Health Innovation, The University of Texas at Arlington, 411 S. Nedderman Drive, Box 19407, Arlington, TX, 76019, USA

    Zhaoli Liu

  2. Department of Biostatistics & Data Science, School of Public and Population Health, University of Texas Medical Branch, Galveston, TX, USA

    Yong-Fang Kuo

  3. Department of Health Services Research, MD Anderson Cancer Center, The University of Texas, Houston, TX, USA

    Sharon H. Giordano

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  1. Zhaoli Liu
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  3. Sharon H. Giordano
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Contributions

All authors contributed to the study conception and design. Dr. ZL acquired and analyzed the data, and also drafted the manuscript. Dr. Y-FK and Dr. SG critically reviewed and edited the manuscript. All authors read and approved the final manuscript.

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Correspondence to Zhaoli Liu.

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The authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

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The institutional review board of the University of Texas at Arlington reviewed the study and exempted it from a full review because the study utilized publicly available data.

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Liu, Z., Kuo, YF. & Giordano, S.H. Disparities in screening mammography utilization among Hispanic women in rural Texas from 2002 to 2018. Cancer Causes Control 34, 963–971 (2023). https://doi.org/10.1007/s10552-023-01738-3

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