Mammography screening beliefs and barriers through the lens of Black women during the COVID-19 pandemic

Cancer. 2023 Sep;129(S19):3102-3113. doi: 10.1002/cncr.34644.


Background: Mammography is an effective screening tool that leads to decreased breast cancer mortality, yet minority women continue to experience barriers. The coronavirus disease 2019 (COVID-19) pandemic has been proven to have negatively affected minority communities, yet its effect on mammography screening habits in Black women is uncertain. The purpose of this study was to evaluate breast cancer mammography screening habits and barriers for Black women in two northeast communities amid the COVID-19 pandemic.

Methods: The study participants were Black women aged 40 years or older who were recruited from community outreach initiatives. Study coordinators conducted telephone surveys to determine mammography screening behaviors, perceptions, and psychosocial factors.

Results: Two hundred seventy-seven surveys were completed. Two hundred fifty-six patients who reported ever having a mammogram became the study population of interest. One hundred seventy-four of these patients (68%) reported having a mammogram within the past year (nondelayed), and 82 (32%) had a mammogram more than a year ago (delayed). Only thirty-one of the delayed participants (37.8%) had private insurance. There was a significant difference in the mean score for mammography screening perceived barriers for nondelayed participants (mean = 9.9, standard deviation [SD] = 3.6) versus delayed participants (mean = 11.2, SD = 4.3, p = .03). There was also a significant difference in the mean score when they were asked, "How likely is it that 'other health problems would keep you from having a mammogram'?" (p = .002).

Conclusions: Barriers to mammography screening for Black women during the COVID-19 era include insurance, competing health issues, and perceptions of screening. Community outreach efforts should concentrate on building trust and collaborating with organizations to improve screening despite the COVID-19 pandemic.

Keywords: Black women; breast cancer; breast cancer screening; breast disparities; coronavirus disease 2019 (COVID-19) pandemic; disparities; mammography screening.

Publication types

  • Multicenter Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Black People
  • Black or African American* / psychology
  • Breast Neoplasms* / diagnostic imaging
  • Breast Neoplasms* / psychology
  • COVID-19 / epidemiology
  • COVID-19 / psychology
  • Community-Institutional Relations
  • Female
  • Habits
  • Health Knowledge, Attitudes, Practice
  • Humans
  • Mammography* / psychology
  • Mass Screening* / psychology
  • New England
  • Pandemics