What is the clinical evidence from this study?

Study design: Observational. Population: Breast cancer screening (n=1223). Primary outcome: Overdue status for biennial screening mammography per USPSTF guidelines (OR 3.94, 95% CI 2.82-5.51, p=<0.0001).

What does this research mean for the field?

Having a last primary care physician visit more than one year ago is the strongest predictor of overdue breast cancer screening status among adult female outpatients. Novelty: ClaimNovelty.INCREMENTAL. Consensus alignment: ConsensusAlignment.NEUTRAL.

What question did this study set out to answer?

The aim was to identify barriers to breast cancer screening and characterize healthcare disparities among women in primary care.

May 30, 2026

Disparities in breast cancer screening: Insights from an adult female outpatient population in the Northeastern United States.

Q: What are the key findings of this study?

Having a last primary care physician visit >1 year ago was the strongest predictor of overdue breast cancer screening status (OR 3.94; 95% CI 2.82-5.51; P<0.0001).

Q: What does this research mean for the field?

Having a last primary care physician visit more than one year ago is the strongest predictor of overdue breast cancer screening status among adult female outpatients. Novelty: ClaimNovelty.INCREMENTAL. Consensus alignment: ConsensusAlignment.NEUTRAL.

Q: What question did this study set out to answer?

The aim was to identify barriers to breast cancer screening and characterize healthcare disparities among women in primary care.

Key Result

Having a last primary care physician visit >1 year ago was the strongest predictor of overdue breast cancer screening status (OR 3.94; 95% CI 2.82-5.51; P<0.0001).

Key Points

The aim was to identify barriers to breast cancer screening and characterize healthcare disparities among women in primary care.
Conducted a retrospective observational study using electronic medical records of women aged 40-74 referred for screening mammography from October 2022 to October 2025.
Collected data from 1,223 patients, analyzing overdue status using statistical tests and multivariable logistic regression.
Controlled false discovery rates with Benjamini-Hochberg q-values.
52.1% of eligible women were overdue for screening mammography.
Significant differences in overdue status were linked to age, race/ethnicity, language, insurance status, and substance use.
Women with Medicaid insurance had higher odds of being overdue (OR 1.73, 95% CI 1.25-2.40, P=0.001), while Spanish speakers were less likely to be overdue (OR 0.47, 95% CI 0.36-0.61, P<.0001).

Study Design

Type

Observational (n=1,223)

Multicenter

Structured PICO

Population

1,223 women aged 40-74 years referred for biennial screening mammography between October 2022 and October 2025 in a large tertiary-care hospital in Hartford, Connecticut.

Outcome

Overdue status for biennial screening mammography per USPSTF guidelines

Significant sociodemographic and clinical disparities exist in breast cancer screening adherence, with time since last PCP visit being the strongest predictor of overdue status.

Main Result

Effect estimate: OR 3.94 (95% CI 2.82-5.51)

p-value: p=<0.0001

Abstract

e13721 Background: Breast cancer (BC) is the most frequently diagnosed cancer among women globally (excluding non-melanoma skin cancer), accounting for 15.4% of cancer-related deaths. Adherence to United States Preventive Services Task Force (USPSTF) recommendations for biennial screening mammography (BSM) among women remains suboptimal. We aimed to identify barriers to BC screening and characterize healthcare disparities within the adult primary care setting of a large tertiary-care hospital in Hartford, Connecticut. Methods: We conducted a retrospective observational study using Epic (Healthy Planet) electronic medical records of women aged 40-74 years referred for BSM between October 2022 and October 2025. The primary outcome was overdue status for BSM per USPSTF guidelines. Variables associated with healthcare disparities were collected for 1,223 patients and compared by overdue status using Wilcoxon rank-sum and Fisher’s exact tests. False discovery rates were controlled using Benjamini-Hochberg q-values. Multivariable logistic regression was performed to assess associations between risk factors and overdue status. Results: Among 1,223 eligible women, 637 (52.1%) were overdue. In baseline comparisons, overdue status differed significantly by age (median 60 vs 58), race/ethnicity (Hispanic/Latino 64% vs 50.7%), preferred language (English 54.6% vs 68.6%), insurance status (Medicaid 25.1% vs 35.6%), substance use (3.4% vs 10.5%), time since last primary care physician (PCP) visit (1 year ago (all p-values 1 year vs ≤1 year 3.94 (2.82, 5.51) <.0001 No visit vs ≤1 year 2.91 (1.87, 4.54) <.0001 OR, odds ratio; CI, confidence interval; P, p-value from Wald test for OR = 1. Note: Multivariable logistic regression was obtained using stepwise selection with entry and retention criteria of α = 0.30 and α = 0.05, respectively.

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