Digital breast tomosynthesis (DBT) availability at breast imaging facilities is similar across low- and high-deprivation areas, but facilities in low-deprivation areas are significantly more likely to offer weekend appointments, according to research published in the July issue of the Journal of the American College of Radiology. The study suggests that access for traditionally underserved populations may be impacted by these differences in scheduling.
Lead investigator Randy C. Miles, MD, MPH, associate professor of radiology at the University of Chicago and assistant editor with the JACR, said, "The widespread adoption of DBT across communities with varying socioeconomic characteristics is encouraging."
Miles and his colleagues evaluated how zip code-level neighborhood deprivation relates to DBT availability at FDA-accredited breast imaging facilities. They found that geographic availability alone does not ensure equitable access to DBT services. The researchers said that additional strategies such as cost-reduction policies and expanded scheduling options are needed to improve uptake among underserved populations.
The study found no difference in copayments and out-of-pocket expenses between low- and high-deprivation areas; however, costs may still disproportionately impact women from lower socio-economic backgrounds due to lower utilization rates observed in previous studies.
"Addressing cost concerns and increasing access through patient-centered strategies, such as expanded online scheduling and weekend appointment availability, represent important next steps to improve DBT utilization across sociodemographic groups," Miles said.
Ian A. Weissman, DO, FACR, a radiologist with the Milwaukee VAMC and past chair of the ACR Patient- and Family-Centered Care Outreach Committee, said, "This impactful study identifies several barriers for women in high-deprivation areas seeking breast screening with DBT. We found that lower-income patients are offered fewer weekend appointments, which can limit access to DBT, as they are less likely to receive paid sick leave. The cost of the breast screening exam, which is disproportionately higher for lower-income patients, also presents a financial barrier. Continuing to raise awareness of health disparities through meaningful research like this and advocating for patients through organizations like the Radiology Health Equity Coalition are critical to ensuring equal access to care for all patients."
