Abstract B101: Assessment and resolution of breast and cervical cancer screening barriers for underserved women in Louisiana

Abstract

Abstract The Louisiana Breast and Cervical Health program (LBCHP) provides breast and cervical cancer screenings and navigation services at no cost to about 5,000 uninsured or underinsured women per year across the state. These low-income, uninsured or underinsured women have barriers that prevent them from receiving screenings and early cancer detection. A core part of the program is to provide navigation services to address these barriers to cancer care. LBCHP navigators provide extra layers of patient-centered education and resources to assist with completion of screening. They intervene on behalf of the patient with clinicians and departments to facilitate ease of navigating large systems. Navigators perform barriers assessments, both initial and ongoing, to anticipate problems and provide resources and support that lead to completion of screening and early cancer detection. This study analyzed the barriers and navigation services provided to 5,316 women at 12 LBCHP provider sites throughout Louisiana. The top five screening barriers identified by the women navigated over the phone were being uninsured (26%), needing information (17%), limited or inflexible appointment times (13%), long wait times (12%) and financial distress unrelated to health insurance (12%). Though cited as an important barrier in the literature, transportation issues ranked a distant 10th, with only 1% of women identifying it as a barrier. The barriers for women who completed screening services paid by LBCHP differed greatly from women who did not receive screening. The women who completed screening services listed their top barriers as uninsured (41%), needed information (20%) and non-English speaking (12%). In contrast, the women who did not receive screening listed their top barriers as financial distress unrelated to health insurance (42%) and screening was a low health priority (34%). The aforementioned two barriers were identified by 8% and 4%, respectively, of women who completed screening. Because cancer screening is a low health priority in Louisiana's unscreened population, it appears that women under financial distress would not prioritize cancer screening. The barriers will be presented by race/ethnicity, geographic location, insurance status and services provided. The results of this study suggest that financial distress is a difficult barrier to overcome and that barriers differ greatly by population. Services provided need to be tailored by the types of barrier encountered. Citation Format: Janet Brown, Nannozi Ssenkoloto, Tyler Bartley, Donna Williams. Assessment and resolution of breast and cervical cancer screening barriers for underserved women in Louisiana [abstract]. In: Proceedings of the Eleventh AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2018 Nov 2-5; New Orleans, LA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2020;29(6 Suppl):Abstract nr B101.