Black women in the U.S. face a troubling disparity in breast cancer outcomes, and new research highlights how social factors are driving later-stage diagnoses. A study of nearly 5,000 Black breast cancer patients found that underutilization of screening mammography was strongly linked to more advanced cancer at diagnosis. Women who missed regular screenings had more than three times the odds of being diagnosed at stage III or IV compared to those who followed guidelines (OR = 3.21, 95% CI 1.90–5.43).
Income also played a critical role. Women living below the federal poverty line were nearly twice as likely to be diagnosed at a later stage (OR = 1.91, 95% CI 1.17–3.10). While lack of insurance and lower education showed elevated risks, these were not consistently significant across all analyses.
The study emphasized that barriers to screening—such as cost, transportation, and lack of information—are especially acute for Black women. Even after the Affordable Care Act eliminated cost-sharing for mammograms, 23% of women aged 50–64 still reported paying out-of-pocket. “Individuals who report paying any proportion of the cost… are less likely to return for another screening,” the authors noted.
Importantly, when women adhered to screening guidelines, the impact of income and insurance on stage at diagnosis was reduced. These findings suggest that policy-level changes—like expanding Medicaid and removing financial barriers—could help close the gap in breast cancer outcomes.
See: “Associations between social drivers of health and breast cancer stage at diagnosis among U.S. Black women” (July 22, 2025)
