Enhancing Breast Cancer Screening: A Use Case for Using Demographic and State All-Payer Claims Database in Rural Northwestern Washington State Counties

Objective: This study examined disparities in mammography screening rates among women in rural northwest Washington, based on data from the Washington State All-Payer Claims Database (WA-APCD). Materials and Methods: A retrospective quantitative analysis was conducted using deidentified WA-APCD claims data (years: 2020–2022). Screening mammograms were identified using current procedural terminology (CPT) codes 77067 and 77063. Proportion Z tests and pairwise comparisons assessed screening rate disparities, across the 983 zip code region and benchmarks at county, state, and national levels. Results: Mammography screening rates in rural counties within the 983 zip codes were significantly lower than benchmarks. In 2020, screening rates for women aged 18–64 years were 24.2%, compared with county, state, and national averages of 32, 34, and 37%, respectively ( P < .05). By 2022, rates improved to 35.7%, though disparities persisted, particularly among women aged 65 and older. Conclusion: Significant screening disparities persist in rural Washington, particularly among older women. The WA-APCD data provide critical insights to support targeted interventions improving preventive care access in underserved populations.