Black women are 11 times less likely than white women to be eligible for supplemental screening for breast cancer under Pennsylvania law, despite recording higher diagnosis rates, according to a new study.
Published in the JAMA Network Open, the study found that fewer Black women are being recommended for supplemental screening due to the Pennsylvania Act 1. Passed in 2023, the act was passed to eliminate costs for supplemental breast cancer screenings under specific criteria. The act, however, leaves many Black women ineligible for the cost cuts.
Based on the information of about 68,478 women, Black women were less likely to meet the law’s criteria, which consisted of having a Breast Imaging and Reporting Data System C or D breast tissue density and a Breast Cancer Risk Assessment lifetime risk over 20%. Those with dense breast tissue are identified as having a risk that’s over five times greater of developing breast cancer.
Although 16% of women were missing BRACT scores, white women were still 11 times more likely to receive supplemental screenings, despite missing these scores.
“Proactive evaluation of the potential impacts of new policies on various patient populations is needed to help prevent new practices from inducing and/or exacerbating existing disparities in breast cancer, mainly as Black women are less likely to qualify for supplemental screening, despite their greater risk of breast cancer diagnosis and death using the BI-RADS breast density definitions,” said the study authors.
Previous studies have found that Black women are more likely to receive false positives when they are screened for breast cancer. According to the National Institute of Health, the false-positive rate for digital mammograms for Black women on average is about 9.2%.
Overall, Black women have higher death rates from breast cancer than any other demographic. Per the Breast Cancer Research Foundation, they have a mortality rate that’s 40% higher than white women, particularly as they are more likely to be diagnosed at later stages in their cancer development.
Study: White Women 11 Times More Likely than Black Women to Be Eligible for Supplemental Breast Cancer Screening in PAhttps://t.co/ZZuo4RF6mR@RadiologyACR @ARRS_Radiology @RSNA @JBI_SBI @BreastImaging @DukeRadiology @WinshipAtEmory @BrighamRad @UNCRadiology #radiology #RadRes pic.twitter.com/4VDutHPIBX
— Diagnostic Imaging (@Dx_imaging) August 10, 2025
The disparity persisted across age groups, as young Black women have double the mortality of young white women.
When diagnosed, Black women are most likely to deal with the most aggressive forms of cancer, such as triple-negative breast cancer and inflammatory breast cancer.
As Black women continue to carry the burden of higher rates of breast cancer, representatives from the American Cancer Society Cancer Action Network have been vocal about increasing access to screening for all women.
“Lawmakers can and must do more to address the unequal burden of breast cancer among Black women, including increasing funding for the National Breast and Cervical Cancer Early Detection Program (NBCCEDP), a program jointly funded by federal and state governments that helps improve access to lifesaving screenings for these cancers,” said the president of ACS CAN, Lisa A. Lacasse.
