Breast cancer claimed 42,863 lives in the US in 2021, but early detection can improve survival rates and reduce the financial, physical, and mental burdens of treatment. Access to screening varies significantly across counties, influenced by local health-care infrastructure and economic conditions.
This report examines disparities in screening capacity, using the number of mammography facilities per person as a proxy for detection quality. Counties with greater capacity report higher rates of breast cancer detection, with more cases caught at earlier stages and longer average survival times. Conversely, areas with higher poverty levels and lower female health insurance coverage tend to have fewer screening facilities, leading to later-stage diagnoses and worse outcomes.
Our simulations show that improving detection in low-capacity counties could identify 17,804 undiagnosed cases and increase early-stage detection by 12.6 percent. These improvements could also reduce treatment costs by an estimated $176 million, as early-stage cases are less expensive to treat. Enhancing screening technology, particularly in underserved areas, offers the greatest potential for reducing disparities and improving outcomes.
Andrew Friedson, PhD, is the head of research for the Milken Institute Health. He is a health economist with expertise in health care and related sectors.
Bumyang Kim is an associate director of research at the Milken Institute Health. He specializes in data-driven, evidence-based quantitative research that applies real-world data analytics to the healthcare delivery system.
Katherine Sacks is an associate director in health economics on the research team at the Milken Institute. Her research concerns health equity, health disparities, and the social determinants of health, focusing particularly on adverse maternal birth outcomes, as well as the effects of the social safety net on measures of population health.
January 14, 2025 (Los Angeles, CA)—Raleigh, NC is the best-performing large metropolitan area, according to the 2025 Milken Institute Best-Performing Cities (BPC) report, taking the top spot in the rankings following two consecutive years...
Paul Guequierre is the director of strategic communications. In this role, he works to increase the profile of Milken Institute in the media, raise the visibility of issues important to the organization and its stakeholders, and expand the Institute's digital presence.
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