Improving breast cancer screening in a rural state: Insights from mobile vs. facility-based mammography.
Year: 2026
Type: conference-abstract
Abstract: 144 Background: Geographic barriers continue to limit access to breast cancer screening for rural populations. Mobile mammography programs have been implemented to improve screening access; however, data comparing screening outcomes and follow-up quality metrics between mobile and facility-based programs remain limited. We evaluated whether mobile mammography achieves screening outcomes comparable to facility-based screening while expanding access to underserved populations in a predominantly rural state. Methods: We conducted a retrospective chart review of women aged 40-74 years who underwent screening mammography within a single health system between January 1, 2020, and December 31, 2025. Women screened through a mobile mammography program were compared with those screened at a facility-based imaging center. Demographic characteristics, residence status, screening outcomes, diagnostic follow-up, and cancer-related outcomes were analyzed. Results: The first 400 women randomly identified were included, with 200 screened through the mobile program and 200 through a facility-based program. Women screened through the mobile program were significantly more likely to reside in small-town or rural communities (66% vs. 33%, p<0.001). Abnormal screening results occurred at significantly higher rates in the mobile than facility-based cohorts (99% vs. 96%, p=0.020), and diagnostic follow-up modalities did not differ significantly (p=0.064). Twenty-four breast cancers were diagnosed, with no significant difference in stage at diagnosis between groups (p=0.194). Median time to diagnosis was 21 days (IQR: 15-28) following mobile screening and 14 days (IQR: 7-23) following facility-based screening (p=0.065). However, recall completion was lower after mobile screening (96% vs. 100%, p=0.003), and median time to recall completion was more than doubled 12 (IQR: 6-20) vs. 5 (IQR: 0-14) days, p<0.001). Missed appointments occurred more frequently among mobile-screened patients (4% vs. 1%, p=0.037), with a trend toward higher no-show rates (3% vs. 0%, p=0.061). Conclusions: Mobile mammography successfully expanded breast cancer screening access among rural women without compromising detection rates, diagnostic evaluation, or stage at cancer diagnosis. However, delayed and incomplete follow-up after abnormal screening findings highlights a critical quality-of-care gap. Enhanced patient navigation, outreach, and care coordination strategies may improve diagnostic follow-up and maximize the effectiveness of mobile mammography programs in rural populations.
Source: JCO Oncology Practice
Institutions: University of North Dakota, Sanford Medical Center
Language: English
Subfield: Oncology
Field: Medicine
Domain: Health Sciences
Open Access status: bronze
OpenAlex ID: W7221587713