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. 2023 Jul;20(7):634-639.
doi: 10.1016/j.jacr.2023.04.006. Epub 2023 May 23.

Impact of High Neighborhood Socioeconomic Deprivation on Access to Accredited Breast Imaging Screening and Diagnostic Facilities

Victoria L Mango  1 , Elizabeth M Stoeckl  2 , Nicholas J Reid  3 , Randy C Miles  4 , Efren J Flores  5 , Ian A Weissman  6 , Amelia Wagner  7 , Alexander Morla  8 , Oyinloye Jose  9 , Anand K Narayan  10
Affiliations

Impact of High Neighborhood Socioeconomic Deprivation on Access to Accredited Breast Imaging Screening and Diagnostic Facilities

Victoria L Mango et al. J Am Coll Radiol. 2023 Jul.

Abstract

Purpose: The aim of this study was to evaluate the presence or absence of accredited breast imaging facilities in ZIP codes with high or low neighborhood socioeconomic deprivation.

Methods: A retrospective ecological study design was used. Neighborhood socioeconomic disadvantage rankings at the ZIP code level were defined by the University of Wisconsin Neighborhood Atlas Area Deprivation Index. Outcomes included the presence or absence of FDA- or ACR-accredited mammographic facilities, accredited stereotactic biopsy or breast ultrasound facilities, and ACR Breast Imaging Centers of Excellence. US Department of Agriculture rural-urban commuting area codes were used to define urban and rural status. Access to breast imaging facilities in high-disadvantage (≥97th percentile) and low-disadvantage (≤3rd percentile) ZIP codes was compared using χ2 tests, stratified by urban or rural status.

Results: Among 41,683 ZIP codes, 2,796 were classified as high disadvantage (1,160 rural, 1,636 urban) and 1,028 as low disadvantage (39 rural, 989 urban). High-disadvantage ZIP codes were more likely rural (P < .001) and less likely to have FDA-certified mammographic facilities (28% versus 35%, P < .001), ACR-accredited stereotactic biopsy (7% versus 15%, P < .001), breast ultrasound (9% versus 23%, P < .001), or Breast Imaging Centers of Excellence (7% versus 16%, P < .001). Among urban areas, high-disadvantage ZIP codes were less likely to have FDA-certified mammographic facilities (30% versus 36%, P = .002), ACR-accredited stereotactic biopsy (10% versus 16%, P < .001), breast ultrasound (13% versus 23%, P < .001), and Breast Imaging Centers of Excellence (10% versus 16%, P < .001).

Conclusions: People living in ZIP codes with high socioeconomic disadvantage are less likely to have accredited breast imaging facilities within their ZIP codes, which may contribute to disparities in access to breast cancer care experienced by underserved groups living in these areas.

Keywords: Area Deprivation Index; Breast imaging; health care disparities; socioeconomic disadvantage.

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Conflict of interest statement

Disclosures/COI: Dr. Mango receives unrelated research funding from Pfizer, Inc. Dr. Flores acknowledges support from the NCI research supplement (3R01CA218123-05), ACR Innovation Grant, and MGH Physician Scientist Development Award for work not related to this manuscript. Dr. Flores received speaker honoraria from Grand Rounds and a speaker honorarium from WebMD/Medscape. The remaining authors declare no conflict of interest.

Comment in

References

    1. [Accessed August 1, 2022]. https://www.acraccreditation.org.
    1. Jemal A, Robbins AS, Lin CC, et al. Factors That Contributed to Black-White Disparities in Survival Among Nonelderly Women With Breast Cancer Between 2004 and 2013 Journal of Clinical Oncology 2018. 36:1, 14–24. - PubMed
    1. Onega T, Hubbard R, Hill D, et al. Geographic Access to breast imaging for US women. J Am Coll Radiol 2014;11:874–882. - PMC - PubMed
    1. Lee CI, Zhu W, Onega T, et al. Comparative access to and use of digital breast tomosynthesis screening by women’s race/ethnicity and socioeconomic status. JAMA Network Open JAMA Network Open. 2021;4(2):e2037546. doi:10.1001/jamanetworkopen.2020.37546 - DOI - PMC - PubMed
    1. Sadigh G, Gray RJ, Sparano JA, et al. Assessment of Racial Disparity in Survival Outcomes for Early Hormone Receptor–Positive Breast Cancer After Adjusting for Insurance Status and Neighborhood Deprivation. JAMA Oncol. doi:10.1001/jamaoncol.2021.7656 Published online February 17, 2022. - DOI - PMC - PubMed

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