Racial, Ethnic, and Regional Influences on National Patterns of Mammographic Screening

Objectives: We sought to evaluate whether there were clinically significant disparities in screening mammography rates according to race, ethnicity, and United States geographic region in patients with access to health care systems. Methods: We queried the Cosmos Epic national database to ascertain mammographic screening rates for women aged 50 to 65 who had 1 or more ambulatory encounters with a primary care physician between November 9, 2020, and November 8, 2023. Patients with a previous breast cancer and those with missing race or ethnicity data were excluded. Results: The overall mammographic screening rate was 63.8% in the 7,837,164 individuals who met study criteria. There were no clinically meaningful differences in screening according to race. However, screening was less frequent in those with Hispanic ethnicity versus non-Hispanic (58.9% vs. 64.3%, P <0.001). Rates also varied according to region, with the lowest rates in the West (55.5%, P <0.001). Screening rates for Black and White groups were within 5% of one another in all 4 regions. With respect to ethnicity, the South was the only region where the Hispanic population rate had a lower rate over 5% (61.8% vs. 55.7%, P <0.001). Conclusions: Many patients receiving health care in the US do not receive recommended mammogram screening, but there were no clinically significant differences by race. Lower rates were noted in Hispanic populations, particularly in the South. Targeted educational and community outreach efforts in this region are warranted.