It was almost a decade ago that a group of clinicians from Boston published a paper in Academic Radiology entitled “Retail venue-based screening mammography: assessment of women’s preferences.” Their findings resulted from a self-administered survey of almost 400 women who were eligible for screening: age > 40 years, and no abnormal mammographic findings in the recent past. More than half affirmed an interest in having their regular screening mammogram done in a private area within a retail shopping centre, with most preferring a pharmacy over Walmart or a grocery store. Appealing factors were proximity to home, free parking and convenient operating hours.
This past week brought the news that Walmart in the state of Georgia had opened up a second health clinic that offers imaging services, including mammography. Sean Slovenski, president of Walmart’s Health and Wellness division, commented: “We think we can make an impactful difference in affordability, convenience and, most importantly, accessibility for the community.” Whereas other retail stores such as Sears have struggled in the era of Amazon, Walmart has been the exception and, as reported in The Wall Street Journal, is using its giant stores to best advantage. Among these advantages are the health clinics with breast imaging facilities staffed by medical professionals.
While there are no Walmart stores in South Africa, the company does have a majority stake in Massmart which operates more than 400 stores in the country, many of them located in retail shopping malls. In addition, South Africa has retail-led healthcare companies such as: Clicks, with 545 in-store pharmacies; Dis-Chem, with over 100 pharmacies, including family clinics; and MediRite, with over 140 pharmacies located within Checkers and Shoprite grocery stores. Many of these pharmacies already offer screening check-ups for blood pressure, cholesterol, blood sugar and body mass index.
As previously highlighted, 20% of South African women have private health insurance and are covered for bi-annual screening – which includes both mammography and ultrasound – at a cost of R1,500 (about $100 at today’s exchange rate). This means that more than 900,000 women should be undergoing breast screening each year, and yet we know that only 300,000 are taking advantage of this prescribed minimum benefit. This translates into a one billion rand (about $60m) market for an enterprising company willing to seize the opportunity.
This brings us back to the original question: Is breast screening ready for retail? We believe the answer is an unequivocal “yes,” where the real beneficiaries will be women whose breast cancer is detected early enough to be treated successfully.