Among high-risk women in the WISDOM trial, BHS consultation completion rates were highest in Midwest (84%) and Other/Mixed race (77%), lowest in Black women (41%) and South region (51%).
Do completion rates of risk counseling consultations vary by age, race/ethnicity, and geography among women at high risk for breast cancer?
Significant demographic and geographic disparities exist in the completion of breast cancer risk counseling consultations, highlighting the need for tailored outreach and improved access.
Absolute Event Rate: 0% vs 0%
Abstract BACKGROUND: The WISDOM study is innovative in that it is the first, prospective large-scale trial of assessing risk-based mammographic screening recommendations versus annual screening. Women identified as high-risk were invited to complete a Breast Health Specialist consultation, which included use of an automated educational tool, Breast Health Decisions (BHD) tool, identifying their specific breast cancer risk factors, and how to promote uptake of risk-reducing options. During initial rollout, the preliminary data obtained demonstrated that racial and ethnic minority populations were underrepresented in the study demographics, thus, we created a program to incorporate a more diverse participant pool. We sought to understand whether completion rates of consultations with trained breast health specialist (BHS) varied among race/ethnicity, geography, and age. METHODS: We analyzed data from WISDOM 1.0 participants that completed the BHD tool from 2015-2023 that were considered being in the highest 2.5% breast cancer risk based on the Breast Cancer Surveillance Consortium. Of those participants, we compared completion of BHS consultations by comparing them by age (40-49, 50-59, 60-69, 70-79), race/ethnicity (White, Asian, Black, Hispanic, Other/Mixed Race), and geography (Northeast, Midwest, South, West). We compared each category by proportions of total completed versus not completed and obtained percentages of each. RESULTS: There were a total of 2883 participants identified as high-risk and offered a BHS consultation. Most of all participants were White (84%) and from the West region of the United States (66%). Completion rates were similar across age groups (52-71%), but lower for women ages 70-79 (52%). Within the race/ethnicity category, the proportions that completed consultations were: Other/Mixed Race 105/137 (77%); White 1666/2434 (68%); Hispanic 76/122 (62%); Asian 42/78 (54%); and Black 46/112 (41%). Lastly, the geographic region with the highest completion rate was the Midwest at 521/623 (84%) and the lowest in the South at 157/306 (51%). CONCLUSION: WISDOM identified women at high risk and provided virtual clinical consultations with breast health specialists to review their personalized risk and discuss breast cancer prevention strategies. There were notable differences in completion of clinician consultations rates seen across categories of age, geography, and race/ethnicity. Further assessment of scheduling availability, structural barriers, participant preferences, clinician contact methods, and other contributing factors is required to understand why completion rates differed so much across demographic groups. Based on these results and participant feedback, the WISDOM 2.0 study has changed consultation workflows, improved clinician availability and scheduling methods. We also plan to increase community engagement, tailor outreach methods based on community member feedback, and offer more options for participants to receive the personalized risk information than were offered in WISDOM 1.0. As a pragmatic and iteratively improving study, WISDOM 2.0 has been funded to create and implement these changes with the goal of providing a more equitable method of providing specialty consultations to high-risk participants. Citation Format: J. Moya, K. Ross, D. Goodman-Gruen, L. Madlensky, A. Blanco, B. Tong, H. Harvey, A. S. Fiscalini, A. Kaster, M. Scheuner, L. Sabacan, J. Atamer, L. van 't Veer, O. I. Olopade, J. Tice, E. Ziv, S. Kapoor, Y. Shieh, A. D. Borowsky, A. Naeim, H. L. Park, A. LaCroix, WISDOM Investigators and Advocate Partners, L. J. Esserman. Completion Rates of Risk Counseling Consultations For Women at High-Risk for Breast Cancer within the WISDOM 1.0 Pragmatic Screening Trial abstract. In: Proceedings of the San Antonio Breast Cancer Symposium 2025; 2025 Dec 9-12; San Antonio, TX. Philadelphia (PA): AACR; Clin Cancer Res 2026;32(4 Suppl):Abstract nr PS3-02-24.
Moya et al. (Tue,) reported a other. Among high-risk women in the WISDOM trial, BHS consultation completion rates were highest in Midwest (84%) and Other/Mixed race (77%), lowest in Black women (41%) and South region (51%).