Abstract C127: Strategies to improve breast cancer screenings among uninsured individuals post COVID-19

Abstract

Abstract MD Anderson Cancer Center at Cooper (Cooper) is located in Camden, NJ, one of the poorest cities in the nation. The Camden County Cancer Screening Project (CCCSP) is a state and federally funded program out of Cooper which provides breast, cervical, prostate and colorectal cancer screening at no cost for uninsured and underinsured individuals. This target group is particularly difficult to screen due to a variety of social determinants of health and other barriers. Like other national sites, routine screenings stopped at Cooper for approximately four months in 2020. This quality improvement project focused on several initiatives to return insured and uninsured vulnerable patients back to mammography screening over the past two years. We also looked to understand barriers to screening prevalent in the community. Cooper undertook a multi-level approach to return our communities to their routine mammography screening. These included opportunities during the pandemic when screenings froze, opportunities when screenings resumed, outreach efforts through CCCSP, and special events with community partners. Efforts included screening postcards, advertisements, letters and phone calls to current patients, email blasts, virtual education, opening evening and weekend hours for mammograms, promoting screenings at vaccine sites, and in-reach to women who were due for screening. In 2020, mammography screenings decreased to 11% less for all of Cooper patients and to 37% for CCCSP compared to 2019 (pre-pandemic levels). In 2021, screenings increased higher than pre-pandemic levels at Cooper by 15% but stayed 25% lower for CCSP. In 2022, screenings increased higher than pre-pandemic levels at Cooper by 25% but stayed 22% lower for CCSP. A survey of 367 Camden community women 40 and older on barriers to screening noted that of the women who never had been screened (25) or had not gotten screened in over 2 years (118), health insurance, perceptions of mammography and transportation were the top barriers to screening. Institutional efforts at Cooper to return women to breast cancer screenings were successful for insured individuals but did not return to the pre-pandemic screening rate for uninsured individuals. A recent internal study noted that fear of screening, compounded by the pandemic, is a major reason for lack of screening for this community. A survey of our community noted insurance, beliefs and transportation as major barriers. As such, as we continue to encourage women back to screening, efforts need to focus on resources to support our underserved community’s concerns. Citation Format: Evelyn Robles-Rodriguez, Plyshette Wiggins, Tondalya DeShields. Strategies to improve breast cancer screenings among uninsured individuals post COVID-19 [abstract]. In: Proceedings of the 16th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2023 Sep 29-Oct 2;Orlando, FL. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2023;32(12 Suppl):Abstract nr C127.