Bolstering insurance coverage more effective than adopting breast density notification laws
Bolstering insurance coverage is more impactful than breast density notification laws at improving cancer care outcomes, according to an analysis published Aug. 7.
Many states have mandated that providers notify patients about dense-tissue concerns, which can make it harder to detect disease via mammography. But there has been little written about the connection between such legislation and the stage of breast cancer diagnosis, Penn State researchers noted.
Using National Cancer Institute data covering hundreds of thousands of women, Chan Shen, PhD, and colleagues found the overall impact of notification legislation has been insignificant. Statutes mandating insurance coverage for supplemental screening of dense breasts, however, produced 6% lower odds of diagnosis at a regional stage.
“Importantly, the study suggests that insurance coverage legislation has a larger impact than notification legislation but that the impacts differ by age and race/ethnicity groups,” Shen, with Penn State Medicine’s Department of Surgery, and co-authors wrote in the American Journal of Preventive Medicine. “To promote early detection of breast cancer, future research studying targeted interventions, such as patient navigation, designed to improve healthcare among specific age and race groups is warranted, with legislation being one important component of an effective multilevel approach,” they advised.
For the study, scientists queried the nationwide Surveillance, Epidemiology and End Results Database, pinpointing patients ages 40-74 diagnosed with breast cancer between 2005-2016. Nearly 690,000 cases met the inclusion criteria. Shen and colleagues found the association between insurance coverage legislation and stage of diagnoses was even strong among women in their 40s. That included 11% lower odds of being diagnosed at the regional stage, and 12% lower at the distant state. Latinas saw an 11% drop in odds of being diagnosed at a later stage due to notification laws, but neither extra screening coverage nor notifications benefited African American patients.
“Additional research is needed to identify the best methods for communicating findings of dense breasts to Black women and to facilitate uniform access to supplemental screening among different racial groups,” the authors noted.
Marty Stempniak has covered healthcare since 2012, with his byline appearing in the American Hospital Association's member magazine, Modern Healthcare and McKnight's. Prior to that, he wrote about village government and local business for his hometown newspaper in Oak Park, Illinois. He won a Peter Lisagor and Gold EXCEL awards in 2017 for his coverage of the opioid epidemic.