It’s never too late. The two most important words for patients to hear about breast cancer screening this year should be: Don’t skip. As the world recovers from the global pandemic, many studies have shown incredible declines in breast cancer screenings and the potential impacts could be devastating.
Providers in women’s health already know that delays or missed screening appointments can have negative impacts on early detection and diagnosis of breast cancer, resulting in many diagnoses at advanced stages and potentially more deaths from breast cancer. It was estimated that over the 20 weeks following March 11, 2020, the volume of screening mammograms and diagnostic mammograms fell by 58 percent and 38 percent on average; by 99 percent and 74 percent just in the week of April 8 to 14. Another study found that 1 million women in the UK missed their mammograms during the height of the pandemic and that about 86,000 women were now living with undetected breast cancer.
Additionally, clinicians are working to eliminate disparities in women’s health that result in significantly higher incidences of cancer and death among certain populations. Even in the pre-pandemic world nearly half of all eligible women miss at least one recommended mammogram; 30 percent of those 50 and older, and in the US, black women are more than 40 percent more likely to die of breast cancer than white women. And in some communities across the US, according to a representative from the Susan G. Komen organization, the disparity is as high as 74 percent.
Improving Access to Care for the Groups with the Highest Cancer Burden
Breast cancer is the most common cancer in women worldwide, representing about 25 per cent of all cancers in women. Screening offers the opportunity to catch breast cancers early, before they have progressed, allowing for better lifetime outcomes. However, some groups of women have remarkably higher chances of getting breast cancer than others. The group that bears the most disproportionate burden of breast cancer is black. The most recent statistics show that breast cancer is the most commonly diagnosed cancer among black women, with 33,840 new cases estimated to have been diagnosed in 2019 alone. The COVID-19 pandemic is expected to have intensified the disparities already felt by under-served communities of color.
Pursuing health equity in breast care is a commitment to strive for the highest possible standard of health for all people, giving special attention to the needs of those at greatest risk. Improving access to care, removing social determinants, sharing scientific information across the globe, and rethinking patient communications are some of the ways clinicians and patient advocates are working to remove the barriers that exist in women’s health.
In order to tackle racial and socioeconomic disparities head-on, clinicians and patient advocate groups are working to identify at risk groups and modify traditional communications, education and outreach in order that access is improved, and outcome statistics can be changed for the better. Breast cancer is a considerable public health burden, and its primary and secondary prevention requires strengthening in every part of the world.  Early detection of breast cancer can reduce mortality and the intensity of treatment required.
Communicating Risk and Improving Education
In addition to the continued focus on improving access and breast health education for underserved communities, breast health providers also need to focus efforts on reaching out to the many patients who missed or delayed screenings during the COVID-19 pandemic.
Under these new circumstances, the value of women understanding their own breast cancer risk factors such as breast density and genetics has become particularly apparent. Randy Miles, MD, Radiologist and Clinical Service Chief for Breast Imaging at Massachusetts General Hospital (MGH) in Boston believes that as the gateway to diagnosis, a radiologist’s role in challenging traditional bias in data and inequality in care is front and center and can be a key influencer of change.
Understanding the health risks or commonalities associated with specific patient communities, cultures, or geographic areas and how they may affect prevalence of disease, detection and treatment is key, as is building trust with patients in communities where the disparities are greatest. Bringing in interpreters or specialized staff to eliminate language barriers and understand cultural influences can help build trust with patients. Ensuring these patients have access to information in local languages, high-quality screening, genetic testing, treatment, and clinical trials are important steps on the path to health equity for all individuals.
He believes strongly that communication is truly the vehicle that can be used to better educate patients, so they are able to advocate for their own health needs. The traditional model of ‘I talk, you listen’ is outdated and ineffective, he says, and clinicians needs to build a rapport with patients and connect with them to establish a trusted relationship to ultimately have an impact on better health outcomes.
Working cooperatively to improve breast care
Industry leaders like GE Healthcare are working together with clinicians and patient advocates to increase awareness about disparities in care, and to identify opportunities to improve health outcomes for at risk groups.
One such example is the one-stop clinic, where facilities are intentionally designed so patients can receive screening results, diagnostic exams and even biopsies on the same day. Not only do these clinics have the potential to resolve patient fears about returning to the hospital or clinical multiple times from a safety perspective, they also help to potentially reduce the amount of time from screening to diagnosis, potentially impact how fast treatment can be initiated and ultimately, it can improve outcomes.
From patient-targeted communication materials and resources about breast health education and screening, to collaborative webinars where experts have collaborated on innovative ideas to improve access to care, and uniquely designed screening tools for breast mammography that improve patient comfort and decrease anxiety about exams, the entire industry is committed to improving health equity in breast care.
For more information on communication tips about breast cancer screening, click here.
For more information about one-stop clinics for breast cancer care, click here.
To read more about the global pursuit of health equity in breast care, click here.
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