| Autor: |
Fazeli S; Assistant Professor, UC San Diego Health, 9400 Campus Point Dr., La Jolla, CA 92037., Narayan A; Vice Chair of Equity, Associate Professor, University of Wisconsin-Madison, 600 Highland Avenue, F6/178C, Madison, WI 53792-3252., Mango VL; Associate Attending Radiologist, Breast Imaging Service, Assistant Director, Global Cancer Disparities Initiatives, Memorial Sloan Kettering Cancer Center, 300 East 66th Street, Suite 715, New York, NY 10065., Wahab R; Associate Professor of Radiology, 1161 21st Ave S, Nashville Tn 37232., Mehta TS; Associate Professor of Radiology, Vice Chair of Diversity, Equity, Inclusion and Faculty Engagement, UMass Memorial Medical Center/UMass Chan Medical School, 55 Lake Avenue North, Worcester, MA 01655., Ojeda-Fournier H; Professor, Division Chief Breast Imaging, UC San Diego Health, 9400 Campus Point Dr., La Jolla, CA 92037. |
| Abstrakt: |
While breast cancer screening reduces mortality, disparities in access continue to limit equitable care. Medically underserved groups-including American Indian or Alaska Native, Black, Hispanic, disabled, and LGBTQ+ individuals-face significant barriers in accessing screening mammography services. This AJR Expert Panel Narrative Review leverages the National Institute on Minority Health and Health Disparities Research Framework to analyze persistent inequities in screening, focusing on race, ethnicity, socioeconomic status, disabilities, health insurance, and geography. Screening guidelines vary across organizations, complicating access for underserved groups. Legislative efforts, including breast density notification laws and the Find It Early Act, aim to address disparities but remain insufficient. Traditional risk models can yield inconsistent assessments of high-risk status and disparities in appropriate referral for genetic testing and supplemental screening. Emerging technologies like artificial intelligence (AI) promise to reduce these gaps by improving risk assessment and detection accuracy, although clinical integration requires careful evaluation to avoid exacerbating existing inequities. This article underscores the importance of policies and practices that address the needs of disabled individuals and other marginalized populations, focusing on creating inclusive and effective screening systems. Recommendations are provided to guide future research, policy development, and clinical practices aimed at mitigating disparities in breast cancer screening. |
