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William J. Gradishar, MD, FACP, FASCO
William J. Gradishar, MD, FACP, FASCO
Posted: Monday, March 18, 2024
Neha Goel, MD, MPH, of the University of Miami, and colleagues observed that women with stage I to IV breast cancer and an increased number of unmet social needs may experience decreased screening mammography and late-stage diagnosis. This observation suggests that patients in either a safety-net hospital or an academic cancer center may benefit from screening for issues such as housing instability, social isolation, food insecurity, and transportation challenges to overcome access to care barriers associated with late-stage disease at diagnosis. These findings were published in JAMA Network Open.
“These results suggest that unmet social needs should be screened at intake at all hospital systems to promote screening utilization and early-stage diagnosis,” said the study authors.
The study included women with stages I to IV invasive ductal or lobular carcinoma treated at a safety-net hospital and a National Cancer Institute–designated academic cancer center from 2020 to 2023. Enrolled patients completed the Health Leads Social Needs Screening Toolkit, which gathers information on the most common social needs affecting patient health. Data from eligible patients were analyzed between July 2023 and September 2023.
The study included a total of 322 patients. Of those women who completed the toolkit, 201 (62%) self-identified as Hispanic; 63 (19%), as non-Hispanic Black; and 63 (19%), as non-Hispanic White. A total of 253 patients (76%) with access to a city-funded screening mammography completed a screening mammogram. Patients at the safety-net hospital were more likely to present with late-stage disease progression compared with early-stage disease progression (15 of 48 [31%] vs 50 of 274 [18%]; P =.04). Patients who did not complete a screening mammography appeared to have an increasing number of unmet social needs (P = .047) and an increasing age at diagnosis (P < .001). The existence of increasing unmet social needs “was significantly associated with late-stage diagnosis above and beyond screening mammography (odds ratio = 1.38; P = .04),” the study authors noted.
Disclosure: For full disclosures of the study authors, visit jamanetwork.com.
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