A longtime program that provided the only mammogram services in the rural Big Bend region has been discontinued, meaning locals will now have to drive for hours to cities like El Paso and Odessa to access potentially life-saving breast cancer screenings.
Lynette Brehm, head of the Big Bend Regional Hospital District, confirmed the news this week, saying the El Paso company that had provided the service with funding help from the district made a “business decision” to cut the program.
Brehm said the company, Desert Imaging, told her of numerous reasons for deciding to cut the program, including stricter state regulations on mammograms and costs associated with dispatching a mobile unit.
“Some of the requirements became a little too restrictive for them, and they are a for-profit company,” she said.
The company did not respond to multiple emailed inquiries about the decision.
“It’s just really, really unfortunate,” said Adrian Billings, a longtime local doctor and rural health expert at Texas Tech University. “It’s yet another example of the limited health care resources in rural areas, and just kind of the underinvestment in our rural health care systems by everybody.”
Billings said the company’s decision speaks to the tough financial reality of offering costly health care services like mammograms in rural areas where the population base and insurance payments aren’t enough to sustain the services.
“The consequences are, you can imagine, that less women are going to be able to travel to Midland, Odessa and El Paso and get potentially life-saving cancer screenings that could possibly catch these breast cancers early when they are curable,” he said.
Earlier this year, a national task force on preventive health care revised its recommendations for when women should begin getting periodic mammograms, lowering the recommended starting age to 40 from 50, as NPR has reported.
Board members of the hospital district, an entity that oversees the region’s indigent care program and other public health initiatives, were set to discuss the news at a meeting Wednesday evening.
Brehm said the district is already exploring options for making mammograms available in the region, which could include the district or another local entity buying a mammogram machine.
“I did let Desert Imaging know that if they are going to sell the machine, or sell the rig that carries the machine, to please let us know, because we’d at least like to look at it,” she said.
Still, she cautioned that mammogram machines can be costly - in the six figures - and wait times to acquire one can stretch over a year.
Brehm said the region’s main hospital - Big Bend Regional Medical Center - has been looking into buying its own mammogram machine for a while.
“I think now with the discontinuation of this program, it kind of gets bumped up to a great priority,” she said, adding that the district could work with the hospital on that effort. (The district and the hospital are separate entities, despite their similar names.)
A hospital spokesperson did not immediately respond when asked if officials there were still looking into buying a machine.
According to Brehm, nearly 300 women in the Big Bend region utilized the mobile mammogram services in the first part of this year, and the district was on track to see about as many people use the service in the second half of the year.
She said there is now a “real possibility” that some Big Bend area residents will simply skip getting a mammogram.
“It’s a real burden to have to take a whole day off for something that is perceived as preventative,” she said. “But the screening can definitely save lives.”
In announcing its revised mammogram recommendations in April, the U.S. Preventive Services Task Force said part of its goal was to reduce racial and ethnic disparities in breast cancer mortality seen across the nation, with Black women 40% more likely to die from the disease than white women.
Texas also sees racial and ethnic disparities - and differences between rural and urban populations - in the rates of women who get regular breast cancer screenings, according to a study published earlier this year by researchers at the University of Texas at Arlington.
The study, led by Zhaoli Liu at the university’s College of Nursing and Health Innovation, found that rural Hispanic women have the state’s lowest mammography screening rates.
In an interview, Liu said the lack of access to mammography services in rural areas is a “significant barrier.”
“A lot of people, they probably have no idea where to get a mammogram,” she said. “So they probably just give up.”
A lack of transportation and general financial challenges are additional barriers to access in rural areas, she said.
