Breast cancer screening barriers are impediments that may prevent women from seeking potentially life-saving early detection services. Understanding and addressing these barriers helps health care organizations develop screening programs that better target certain groups of women. Breast cancer is the second deadliest type of cancer for American women, second to lung cancer. Removing screening barriers may help improve mortality rates.
Racial Barriers
In the August 2003 issue of the Journal of the National Medical Association, Dawn M. Harris wrote that while white women have a 13 percent greater risk of getting breast cancer, black women die from breast cancer at a 28 percent higher rate. This disparity is partially due to racial differences in breast cancer screening. Harris' research revealed that white women are more likely to know how to perform breast self-exams. When physicians inform black women about self-exam guidelines and procedures, their compliance rate actually exceeded that of white women.
Emotional Barriers
Some women experience feelings of fear, anxiety or trepidation at the prospect of undergoing breast cancer screening. While normal, these feelings can serve as a deterrent to obtaining breast cancer screening. In the April 2004 issue of Cancer Epidemiology, Biomarkers & Prevention, Nathan S. Consedine, Ph.D., reported that when women fear screening tests, they are more likely to avoid breast cancer screening, thereby avoiding the source of the anxiety. To address emotional barriers, researchers must further study different components of the breast screening process and identify those aspects that cause the greatest anxiety and screening aversion.
Geographical Barriers
Women who live in rural areas are less likely to obtain breast cancer screening than those who live in urban areas. In 2008, the U.S. Centers for Disease Control and Prevention tracked the number of women over 40 who obtained at least one mammogram within a two-year period. Women living in urban areas had a 69 percent compliance rate. Women living in rural areas had a 60 percent compliance rate. These differences are due to disparities in income, education and insurance coverage.
Physician Barriers
Even a physicians can sometimes be a breast cancer screening barrier. Physician recommendations significantly increase mammogram screening rates. Yet physicians tend to recommend mammography more frequently to their female patients who are well-educated, white and married, with annual incomes of more than $20,000, according to a 2001 article by Elizabeth Ann Coleman, Ph.D., published in the Journal of Women & Aging. There are also age disparities for physician-recommended mammograms. Women ages 65 and older report more frequently that they have not received a physician recommendation for a mammogram, despite the fact that Medicare covers the cost of mammograms.
References
- Cancer Causes Control; Which Women Aren't Getting Mammograms and Why; Helen I. Meissner, Ph.D.; February 2007
- American Cancer Society: Breast Cancer
- Journal of the National Medical Association; Racial Differences in Breast Cancer Screening, Knowledge and Compliance; Dawne M. Harris; August 2003
- Cancer Epidemiology, Biomarkers & Prevention; Fear, Anxiety, Worry and Breast Cancer Screening Behavior; Nathan S. Consedine, Ph.D.; April 2004
- Journal of Women & Aging; Racial Differences in Breast Cancer Screening Among Women from 65 to 74 Years of Age; Elizabeth Ann Coleman, Ph.D.; Summer 2001
