Abstract PS5-10-03: The Influence of Sociodemographic Factors on Barriers to Breast Cancer Screening

Abstract Background: Identifying barriers to cancer screening is essential for developing effective strategies to enhance organized screening programs. Aims: This study aims to investigate the impact of sociodemographic factors on barriers to breast cancer screening in the state of São Paulo, a region marked by significant socioeconomic disparities. Methods: A cross-sectional study was conducted using a representative sample of women aged 50 to 69 years, who were users of the Brazilian Health System. Data were gathered through a semi-structured questionnaire designed to assess sociodemographic factors and barriers to breast cancer screening. The sociodemographic factors analyzed as independent variables included age group (50-59; 60-69); education (illiterate; elementary; high school; college graduate); income relative to the minimum wage (<1 minimum wage; 1-2 minimum wages; ≥2 minimum wages); skin color (white; brown; black; yellow); employment status (employed; unemployed); type of employment (domestic work; private sector; public sector; employer; self-employed; unpaid worker); municipality of residence (Metropolitan Region of São Paulo; countryside 1; countryside 2); presence of chronic disease (yes; no); and health insurance (yes; no). Barriers to breast cancer screening were analyzed as dependent variables, grouped into six personal barriers (fear of diagnosis, embarrassment, other priorities, work schedule, pain, and forgetting to schedule) and four system-related barriers (difficulty scheduling the test, long wait time, distance to the screening facility, and difficulty obtaining results). These barriers were assessed through a 5-point Likert scale and logistic regression models were used to examine the relationships between the sociodemographic factors and cancer screening barriers. Results: The most common personal barrier to breast cancer screening was pain during mammography (59%), while the primary system-related barrier was long waiting times (44%). Regarding individual barriers, women with chronic diseases were more likely to fear discovering a serious issue (OR: 3.01; 95% CI 1.2-7.5). Residing in the metropolis was associated with higher odds of embarrassment (OR: 4.7; 95% CI 3.0-7.2) but showed an inverse relationship with pain (OR: 0.3; 95% CI 0.0-0.5). Women with brown and black skin were more likely to feel embarrassed during examination (OR: 2.5; 95% CI 1.2-3.6), while being employed was linked to forgetting to schedule the exam (OR: 3.3; 95% CI 2.1-5.9). Regarding system-related barriers, residing in the metropolis was associated with greater difficulty in scheduling a mammogram (OR: 2.7; 95% CI 1.3-5.8). Furthermore, employment status, having only elementary education, and being brown or black were linked to longer waiting times for results (OR: 3.0; 95% CI 1.5-7.1, OR: 2.9; 95% CI 1.3-6.3, and OR: 2.2; 95% CI 1.1-3.9). Conversely, employment status showed an inverse association with difficulty in scheduling a mammogram (OR: 0.4; 95% CI 0.1-0.7). Conclusion: Barriers to breast cancer screening differ based on sociodemographic factors. Brown or black skin color, residence in the metropolis, employment status, and chronic diseases were predictors of women-related barriers, while brown or black skin color, lower education levels, employment status, and living in the metropolis were predictors of system-related barriers. To improve mammography coverage and successfully implement an organized breast cancer screening program, it is essential to engage healthcare managers in developing key strategies to overcome these barriers. Collaborative efforts are crucial to ensure equitable access to screening and reduce disparities in breast cancer outcomes. These findings offer valuable insights for guiding the implementation of organized breast cancer screening programs in middle-income settings. Citation Format: A. B. Câmara, C. Luizaga, L. Cury, C. Carlos, R. López, A. Carvalho, B. Partha, W. Victor. The Influence of Sociodemographic Factors on Barriers to Breast Cancer Screening [abstract]. In: Proceedings of the San Antonio Breast Cancer Symposium 2025; 2025 Dec 9-12; San Antonio, TX. Philadelphia (PA): AACR; Clin Cancer Res 2026;32(4 Suppl):Abstract nr PS5-10-03