Abstract C150: The association between discrimination and mammography screening: Cross-sectional survey results from the National Health Interview Survey

Abstract Purpose: Racial discrimination has been directly linked to adverse health outcomes among historically underserved racial and ethnic groups. In breast oncology, racial disparities in breast cancer outcomes and mortality persist despite significant advances in early detection and treatment. Although the issues of racial disparities in breast cancer outcomes have been well documented, there is limited data regarding the potential impacts of discrimination and adherence to recommended mammographic screening. The purpose of our study was to evaluate the association between measures of discrimination and mammography screening using a nationally representative cross sectional survey. Methods: Female survey respondents aged 40-74 in the 2023 National Health Interview Survey (NHIS) without history of breast cancer were included. Measures of discrimination were assessed using the Everyday Discrimination Scale (EDS), a measure of the subjective experiences of daily discrimination experienced by minoritized populations. Proportion of patients who reported mammographic screening within the last year was estimated, stratified by measures of discrimination. Multiple variable logistic regression analyses were conducted to evaluate the association between discrimination and mammography screening, adjusted for potential confounders. All analyses were performed accounting for complex survey design features (weighting, stratification, clustering). Results: 8,258 weighted survey respondents met inclusion criteria. Overall, 47.6% of patients reported feeling disrespect, 29.1% poor service, 26.9% not smart, 10.6% afraid, 12.5% harassed. Black participants were more likely to report being treated with less respect (p = 0.011) (Figure 1), receiving poor service (p < 0.001), people acting as if they are not smart (p < 0.001), and people acting as if they are afraid (p < 0.001). 59.5% of women reported undergoing a screening mammogram within the last year. Overall, people acting as if they are afraid of them (OR 0.857, 95% CI 0.737 to 0.997, p = 0.046) and being threatened or harassed (OR 0.850, 95% CI 0.734 to 0.985, p = 0.031) were associated with statistically significantly decreased mammography screening percentages. Disrespect (p = 0.284), poor service (p = 0.176), and being perceived as not smart (p = 0.187) were not associated with statistically significant differences in mammography screening percentages. Conclusion: In a nationally representative cross-sectional survey, nearly half of all survey participants reported experiencing at least one measure of discrimination with Black participants being more likely to experience measures of discrimination. Participants who reported feeling threatened or harassed or participants who reported that people felt afraid of them were less likely to report mammography screening within the last year. Citation Format: Arissa Milton, Lewis Jordan, Jade Anderson, Randy Miles, Anand Narayan. The association between discrimination and mammography screening: Cross-sectional survey results from the National Health Interview Survey [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 C150.