Mobile mammography units are not cannibalizing facility-based breast cancer screening

Mobile mammography units are not cannibalizing facility-based breast cancer screening, according to new research from the Neiman Health Policy Institute. 

Such roving imaging vans have been posed as a way to reach more women in rural and underserved communities. However, their deployment could raise concern for those investing in imaging centers with higher overhead costs and potentially stricter regulatory oversight. 

Experts with the American College of Radiology-affiliated research outfit sought to better understand mobile mammo use, sharing their findings in the journal Clinical Breast Cancer [1]. They emphasized that these units appear to be reaching new patients, rather than stealing them away from local hospitals and imaging centers. 

“Our results show that mobile mammography is not cannibalizing facility-based mammography,” Casey Pelzl, senior economic and health services analyst at the policy institute and lead researcher on the study, said in a statement shared Friday. “It provides additive access to breast cancer screening. What’s more, it reaches women who might not otherwise get screened, and thus presents a complementary approach to facility-based mammography that may reduce access disparities and increase early detection of breast cancer." 

For the study, researchers analyzed a 5% representative sample of fee-for-service Medicare claims spanning 2004 to 2021, extrapolating to represent the entire population covered by the program. Among more than 2.63 million screening eligible women, about 1.3 million (or 49.5%) had a mammogram during the study period. Of those, fewer than 5,000 (or 0.4%) did so via a mobile imaging unit. 

When controlling for various factors, women in low-income communities were 41% more likely to use mobile mammography versus those living in above-average economic conditions. Those in rural geographies were 210% more likely compared to urban areas, and 453% more so when comparing American Indians/native Alaskans to white women.

“Hence, our findings suggest that mobile mammography may be particularly helpful in increasing breast cancer screening among these women and other underserved groups,” study co-author Eric Christensen, PhD, research director at the Neiman Institute, said in the same announcement. 

The study has some important limitations, including its exclusion of uninsured women, along with those using Medicare Advantage, Medicaid or private insurance. Additionally, it’s possible that women included in the study had mammograms and breast health issues prior to enrolling in Medicare, which could bias the interactions captured within the dataset. Still, the authors believe their findings offer important insights into how mobile mammography might increase screening uptake for underserved populations.

“Future studies will include [a] larger dataset of women of screening age to understand trends outside Medicare populations and will assess mammography outcomes, such as cancer detection rates, to demonstrate comparative clinical efficacies of [mobile] and [facility-based mammography],” the authors concluded. “Although there are hurdles to the operational and economic sustainability of MM programs, increasing mammography access through MM presents an opportunity to target underserved populations where improvement of breast cancer screening could have the greatest impact among those who are disproportionately affected by this disease.”