Abstract A50: Impacts of poverty threshold and health insurance on breast cancer screening in California

Abstract

Abstract Background: Breast cancer screening rates have been stabilized in California. Although the effect of health insurance on breast cancer screening is well-documented in United States, the effect in California is not clear. The purpose of this study was to assess the association between having health insurance and being screened for breast cancer by different poverty threshold after controlling for observed factors Methods: Data from the 2007 California Health Interview Survey were used to examine the association of health insurance coverage on breast cancer screening among all women ages ≥40 years (N= 24,060) using logistic regression model. After adjusting for educational attainment, employment status, race, marital status, age, nativity, smoking and doctor visit, potential effects of health insurance on breast cancer screening were analyzed by different groups: all women, women with ≤199 FPL (Federal Poverty Line) and women with 200+ FPL. All analyses accounted for the California Health Interview Survey sampling design. Results: Overall, participants who reported having health insurance coverage were twice as likely to report being screened for breast cancer compared with those who reported having none [OR, 2.11; 95% confidence interval (95% CI), 1.73-2.57]. After adjusting for independent variables, self-reported insurance coverage had positive associations with report of being screened among women below federal poverty line (OR, 1.89; 95% CI, 1.40-2.55) and among women above federal poverty line (OR, 2.40; 95% CI, 1.78-3.24). Conclusions: Women who reported having health insurance were more likely to report having breast screening than those who reported not having insurance coverage. This effect was higher for women at a higher income level. These findings, if confirmed in other study populations, indicate that improving breast cancer screening coverage may require not only insurance coverage but also income level for poverty. Citation Information: Cancer Epidemiol Biomarkers Prev 2010;19(10 Suppl):A50.