Background: Medical literature has highlighted breast cancer screening and survival disparities across various racial and ethnic populations in the United States. However, specific discussions about Native American women are limited. Native Americans have the lowest breast screening rates of any racial group and higher mortality compared to the general population. These disparities have persisted despite efforts such as the Breast and Cervical Cancer Mortality Prevention Act of 1990. Since 1990, the breast cancer mortality rate in Native American women has been unchanged while the mortality rates for white and black women have decreased by 40% and 26%, respectively. Additionally, Native American women are often diagnosed at later stages of breast cancer than white women, with similar rates of invasive and advanced stage diagnoses as black women. Disparities in screening and treatment may be partly attributed to the unique barriers faced by Native American women when accessing care. These barriers include geographical limitations, lack of transportation, low health literacy, conflicting cultural beliefs, and limited insurance coverage. Furthermore, nearly 2.6 million Native Americans receive healthcare coverage through the federal Indian Health Services, which limits facilities where patients may seek care without facing high out of pocket costs.
Learning Objectives: After this session, participants will be able to: 1. Explain the data addressing breast cancer disparities for Native American women regarding screening, incidence, stage of diagnosis, and mortality 2. Describe barriers to accessing breast cancer screening and treatment for Native American women 3. Identify benefits and limitations of existing resources through government sponsored Indian Health Services 4. Develop novel approaches to facilitate screening in this underserved population
Abstract Content/Results: Breast cancer disparity data and access barriers will be presented using explanatory historical text, tables and graphs, anecdotal quotes, and images. The Indian Health Services will be explained with explanatory historical text, images, and data tables. Novel approaches to facilitate screening in this population will be described using images, graphs, and data tables.
Conclusion: There are 33 states encompassing 326 federally recognized Indian Reservations and nearly 2.6 million insured individuals through Indian Health Services. Native Americans are a widespread group with unique access barriers for breast cancer screening and treatment. Therefore, it is essential for breast radiologists to be familiar with the barriers faced by this population. By understanding these challenges, radiology practices will be better positioned to improve breast health care and access for Native American women.
