
Social Determinants of Health May Influence Undiagnosed Breast Cancer Risk
Research presented at this year’s annual meeting of the Radiological Society of North America shows the possible impact of food or housing insecurity on follow-up appointments for breast cancer.
Research presented at this year’s annual meeting of the Radiological Society of North America
“Diagnosing breast cancer at an early stage is very important for survival,” said Aaron Afran, a third-year medical student at Boston University School of Medicine (BUSM),
Two groups of women who had breast imaging done at Bostom Medical Center (BMC) between January 2015 and December 2018 had their medical records retrospectively reviewed:
- Group 1 had 4959 women. They had a screening mammography and subsequently were recommended for diagnostic imaging. Their
BI-RADS score was 0, the mean age was 59.1 years, and a majority (56.2%) were Black. - Group 2 had 3028 women. They had diagnostic breast imaging and subsequently were recommended for biopsy. Their BI-RADS score was 4 or 5, the mean age was 60.9 years, and most (57.5%) were Black, as well.
For diagnostic imaging to biopsy, the longest lapses were seen with food (P < .001) and housing insecurity (P < .001), whereas having at least 1 SDOH (P < .001) or transportation issues (P = .0016) was linked with shorter lapses. Between screening mammography and diagnostic imaging, housing and food again exerted the most influence at extending the lapse, at P = .08 and P = .1405, respectively.
All of the women completed the BMC’s
Afran posited that food and housing insecurity are simply more important priorities than imaging appointments among the patients studied.
“To best serve our patient population at a safety-net hospital, we must think creatively about the social factors that are preventing our patients from receiving the best care,”
Previous research mirrors their findings, reported Afran, in that the issue of later breast cancer stage at diagnosis has been shown to be influenced by poverty, lack of education, and social isolation.
Suggested areas of future study include analyzing the effects of these findings on survival and those of specific interventions.
Reference
Afran A, Donghoon S, LeBedis C, Fishman MDC. The impact of social determinants of health on breast imaging utilization. Presented at: RSNA 2020; November 29-December 5, 2020. https://press.rsna.org/pressrelease/2020_resources/2227/video_4.mp4
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