Latinas See Disparities in Breast Cancer Screening, Age of Diagnosis

August 17, 2023 - Hispanic or Latina women get diagnosed with breast cancer at a younger age than their counterparts of other races, but that’s not because of more habitual breast cancer screening access.

In fact, new data from Epic Research shows that Hispanic women are the least likely to have a recent breast cancer screening documented in the EHR, despite getting a diagnosis at an earlier age. This indicates that Hispanic women are going in for care because they detect lumps or other warning signs on their own. That could mean later-stage cancer and a poorer prognosis, although the researchers did not specifically look into those areas.

Getting a regular mammogram is a critical part of women’s healthcare. The US Preventive Services Task Force (USPSTF), the independent body that lays out guidelines for preventive services, advises that women get breast cancer screening every other year starting at age 40.

Breast cancer screenings are important for detecting cancer early on, which USPSTF says can reduce the risk of mortality and improve quality of life. The entity notes that these benefits outweigh any potential risks—like false positives—associated with breast cancer screening at an early age.

The Epic Research team looked at 484,177 breast cancer diagnoses between 2018 and 2023 to get a better handle on the typical age at which a woman gets a breast cancer diagnosis.

READ MORE: Expanding Cancer Screening Access Beyond Charity Care

That age, 63.2 years old, stayed about the same over the five-year study period, with a few slight fluctuations. Generally, women who were diagnosed with breast cancer between 2018 and 2023 were in their early to mid-60s.

But there was some variation based on race and ethnicity, the data showed. White women were the oldest when they were diagnosed with breast cancer, an average of 64.5 years old. Black and American Indian/Alaska Native (AI/AN) women were around the same age at their diagnosis, 61.7 and 61.1 years old, respectively.

Native Hawaiian/Other Pacific Islander women were 59.2 years old, and Asian women weren’t much younger, with an average age of 58.1 years old at diagnosis.

Latina/Hispanic women were 57.2 years old, which shakes out to more than seven years younger than the typical White woman when she is diagnosed with breast cancer.

However, the disparities in diagnosis age are not the result of breast cancer screening access at a younger age, the researchers said. Even though they were the youngest at breast cancer diagnosis, Latina women were the least likely to have a recent mammogram on the books of any studied race/ethnicity.

Around four in 10 (38.4 percent) Latina women had a recent mammogram documented in the EHR. That compares to 41 percent of AI/AN women, 42.7 percent of Asian women, 47.3 percent of Black women, 47.9 percent of White women, and 49.4 percent of Native Hawaiian/Other Pacific Islander women.

What’s more, fewer than two in five Latina women with a breast cancer diagnosis received a screening the year prior to the diagnosis, the researchers said. In other words, it likely wasn’t a mammogram that caught breast cancer at a young age.

Instead, the researchers posited that Latina women experience breast cancer symptoms, like a lump or other changes in the breast, on their own and then seek care.

This could have an impact on prognosis, although the Epic Research report did not delve into this area.

“Further research on the stage of cancer at the time of diagnosis would give us more insight into the prognosis for different population groups,” Kersten Bartelt, RN, clinician at Epic Research, said in an email statement to PatientEngagementHIT. “It would also be helpful to study the 5-year survival rates in those groups from the time of diagnosis.”

However, there is some evidence that cancers detected via screening can have a better prognosis. According to the American Cancer Society, breast cancers that are detected from a screening tend to be smaller and are less likely to have spread to other parts of the body. That could increase the odds of a good prognosis, ACS says on its website.

The Epic Research data makes clear the gaps in breast cancer screening by race/ethnicity. As the healthcare industry works toward health equity, it will be essential to uncover the underlying factors behind those screening gaps. From there, providers can design patient engagement strategies intended to increase care access.

“There may be any number of factors contributing to this, including language barriers leading to a lack of awareness or difficulty in scheduling and socioeconomic factors that pose financial barriers or transportation issues, Bartelt advised. “Understanding each patient's financial, linguistic, and transportation needs is a good first step in any effort to increase access to screening services.”