Abstract B80: Evaluation of annual mammographic rescreening among uninsured minority women in Northern Manhattan.

Abstract

Abstract Introduction: The goals of this study are to evaluate the rate of annual screening mammography and to identify factors related to mammographic rescreening among a cohort of uninsured, primarily Latina and African American women who obtained a mammogram through the Northern Manhattan Cancer Screening Partnership (NMCSP) during 2008. Background: The effectiveness of screening mammography is dependent on annual screening, making consistent annual screening an important part of preventive care. Disparities in screening mammography rates between Latinas, African American, and non-Hispanic White women have decreased in recent years, but Latina and African American women still have significantly lower rates of continued annual screening compared to non-Hispanic Whites. Lower rescreening rates may help explain why minority women are more often diagnosed at a later stage of breast cancer than non-Hispanic Whites. Lack of health insurance and related financial concerns are also predictive of lower rates of breast cancer screening, and are connected to health disparities like those for breast cancer mortality. Methods: Programmatic records of women aged 40 years and older, meeting program eligibility criteria (annual income <250% FPL, no breast cancer screening within the past 11 months, and medically uninsured) who received a mammogram in 2008 will be followed through June 2012 to determine the rate of annual rescreening. Women will be characterized by several personal characteristics including basic demographics, personal screening history, and family history of cancer. Programmatic factors such as how the patient heard about the program will be also considered. The outcome measure of rescreening compliance will be obtained through analysis of program records of women for whom there is evidence of continued uninsuredness and program participation. Those women receiving three or more mammograms within the 4.5 year time frame will be considered compliant with annual mammographic rescreening. This definition of screening compliance follows the New York State Cancer Screening Services guidelines, which recommends mammography every 12-18 months. Data will be analyzed using SAS to create a comparison between women who return for annual mammograms and women who do not return for annual mammograms across multiple variables. Results: Nearly 4,000 women received a mammogram through NMCSP in 2008. Of these, we hypothesize that less than 50% return for rescreening. Implications: Given that annual screening increases detection of early stage breast cancer by 30%, adherence to screening guidelines is an important part of reducing outcome disparities that result from late stage at diagnosis. Findings from this study will be used to develop future interventions to improve rates of mammography rescreening at NMCSP and may have broader implications to other organizations caring for similarly disadvantaged minority populations. Citation Format: Andrea Mattocks, Grace Clarke Hillyer, Karen Schmitt. Evaluation of annual mammographic rescreening among uninsured minority women in Northern Manhattan. [abstract]. In: Proceedings of the Fifth AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2012 Oct 27-30; San Diego, CA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2012;21(10 Suppl):Abstract nr B80.