Abstract C122: Barriers to mammograms: Examining sociodemographic disparities in breast cancer screening

Abstract Background: Disparities in healthcare access and screening are associated with disproportionately higher mortality rates from breast cancer (BC). Mammography is a critical tool for early detection and improving survival, reducing BC mortality by 40-60%. Despite proven benefits, significant disparities in mammography utilization persist in the US among different demographic and socioeconomic groups. While individual barriers have been identified, a comprehensive understanding of how multiple sociodemographic factors influence screening remains limited. This study examines sociodemographic factors associated with barriers to mammography. Methods: Using All of Us Research Program database, we analyzed individuals assigned female at birth, aged 45-85 years. Variables included demographic (age, race/ethnicity, gender identity, marital status, birthplace), socioeconomic status (income, education, insurance status, Area Deprivation Index (ADI)), access to care (transportation issues, rural healthcare delays), health literacy (English proficiency, ease of understanding health information, care preference discussions), experiences of discrimination and disability status. Multivariable logistic regression was used to assess associations between these variables and receiving a mammogram, adjusting for potential confounders. Results: A total of 53,843 participants were included in the analysis with a mean age of 61. One of the significant predictors of receiving a mammogram was older age (Odds Ratio (OR) = 1.03, 95% Confidence Interval (CI): 1.03-1.03, p<0.001). Factors associated with lower odds of mammograms were transgender/non-binary gender identity (OR = 0.70, 95% CI: 0.52-0.93, p=0.015), high ADI (OR = 0.49, 95% CI: 0.47-0.51, p<0.001), disability status (OR= 0.77, 95% CI: 0.71-0.82, p<0.001), difficulty understanding health information (OR= 0.88, 95% CI : 0.81-0.96, p<0.001), provider not asking for care preferences (OR = 0.94, 95% CI: 0.89-0.99, p = 0.045), lack of provider-patient similarity (OR = 0.95, 95% CI: 0.90-0.99, p = 0.013), and less than college education (OR = 0.83, 95% CI: 0.78-0.89, p<0.001). Conclusions: Our findings enhance our understanding of disparities in mammography screening rates associated with demographic, socioeconomic, and access-related barriers. Addressing these factors through improved access to care, reducing discrimination, enhancing health literacy, and fostering better patient-provider communication may help reduce disparities in BC screening. Citation Format: Daniel Sabater Minarim, Joshua Durkin, Kylie Morgan, Sakshith Chintala, Brent Rose, Matthew Banegas. Barriers to mammograms: Examining sociodemographic disparities in breast cancer screening [abstract]. In: Proceedings of the 18th AACR Conference on the Science of Cancer Health Disparities; 2025 Sep 18-21; Baltimore, MD. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2025;34(9 Suppl):Abstract nr C122.