Racial, ethnic, and regional influences on national patterns of mammographic screening for breast cancer.

1600 Background: Racial, ethnic, and geographic factors can affect disparities in medical care. Mammographic screening has been demonstrated to reduce the risk of breast cancer death for appropriate subsets of women and accordingly is an accepted standard recommendation. Herein, we studied the utilization in screening mammography in patients who have access to primary care physicians according to race, ethnicity, and United States geographic region. Methods: We queried the Cosmos Epic national database to ascertain mammographic screening rates for women aged 50 to 65 who had 1 or more encounters with a primary care physician. Patients with a previous breast cancer and/or ductal carcinoma in situ history and those with missing race or ethnicity data were excluded. Results: The COSMOS database was queried for the period of 11/9/2020 – 11/8/2023. A total of 7,837,164 individuals met our study criteria. The overall rate of positive mammographic screening was 63.8%. Because of the large sample size, small differences in screening rates according to analyzed variables reached statistically significant differences. Accordingly, we defined a clinically relevant low rate of mammography screening for a specific variable as a utilization rate of less than 60%. Using this methodology, there were no differences noted according to race. Both Black/African American and Asian groups had a slightly higher screening rates than Whites. However, the data indicate that rates varied according to ethnicity. Mammographic screening was less frequent in Hispanic/Latino versus not Hispanic (58.9% vs. 64.3%). In addition, rates varied according to census US regions with the lowest rates in the West region (55.5%). Rates of mammographic screening for Blacks/African American and Whites were within 5% of one another in all four of the geographic regions. With respect to ethnicity, the South region had the only difference exceeding 5%, with respective rates of 61.8% for Not Hispanic/Latino versus 55.7% for Hispanic Latino. Conclusions: Many patients receiving health care in the United States do not undergo recommended mammogram screening. We found no clinically significant difference in screening rates according to race but identified a lower rate in Hispanic/Latino populations, particularly in the South. Targeted educational efforts and community outreach efforts in this region are warranted.