Abstract PS5-11-22: Disparities in Mammography Screening in a Welfare-State Healthcare System: Data from 100,000 Women in Israel

Abstract Background: Breast cancer is the most common malignancy among women in Israel and globally. Although early detection significantly improves prognosis, 30% of women in Israel are diagnosed at a locally advanced or metastatic stage. In the early 1990s, Israel implemented a national breast cancer screening program, offering biennial mammograms at no cost to women aged 50 and older at average risk. Such organized programs, which provide free and accessible mammography, have been shown to improve adherence rates. Despite this, a substantial proportion of women do not participate in regular screening. Objective: To evaluate adherence to national mammography screening guidelines among Israeli women and identify sociodemographic and clinical factors associated with adherence. Methods: This population-based retrospective study included 100,000 women aged 35-75, using data collected between 2006 and 2020 from the centralized healthcare registry of Clalit, the largest health maintenance organization (HMO) in Israel. Women with a personal history of breast cancer, prior breast surgery, or known genetic predisposition were excluded. Adherence was defined as the proportion of recommended mammograms completed, categorized as: