Abstract C81: A systematic review of breast cancer screening strategies for African American women

Abstract

Abstract BACKGROUND: Breast cancer mortality is higher among African American women (AAW) in comparison to any other racial/ethnic group. This disparity is reflective of multiple factors including health care access, biological factors and participation in screening mammography. Currently there is a scarcity of literature on evidence-based interventional strategies to increase AAW's participation in screening mammography. Our study aims to: 1) Identify the literature from 2009-2015 on interventional strategies to increase the participation of AAW ≥40 years old in screening mammography and 2) Summarize the evidence from this literature including any impact of these interventions on breast cancer outcomes. METHODS: We conducted a systematic review of published and grey literature on breast cancer screening interventions from 2009-2015. The literature search was conducted in PubMed, Embase (Elsevier), CINAHL (Ebsco), PsycINFO (Ebsco) and the Cochrane Central Register of Controlled Trials (Wiley). Grey literature was searched for using ClinicalTrials.gov, National Cancer Institute's clinical trials database and ProQuest Dissertations and Theses database. Queries utilized a combination of keywords and database-specific terminology derived from pre-determined eligibility criteria. The four reviewers were divided into two teams to balance expertise in public health, primary care, cancer disparities, breast oncology and breast cancer basic science research. The review protocol was developed with guidance from PRISMA standards. Methodological quality of the studies will be determined by examination of study design, theoretical framework and quality of data reporting. RESULTS: Our literature search yielded a total of 1,83O studies. After removal of duplicates, 1,274 studies were screened for inclusion. Twenty studies met all criteria and were designated for abstraction and data analysis. Nineteen studies presented original data from a US based intervention and had a population which included AAW ≥ 40 years old. Study designs included: randomized control trials, quasi-experimental, pre/post study, non-randomized with controls, cohort and case-control studies. The common interventional strategies employed were reminder systems; trained volunteers; media campaigns; telephone and DVD coaching; and patient navigation/case management. Reported outcome measures included: demographics, pre- and post-intervention mammography participation, and intervention retention rates. Study limitations stemmed from limited sample size, lack of generalizability, absence of theoretical framework, attrition rate and utilization of self-reported data. CONCLUSION: Despite knowledge of disparities in breast cancer mortality for AAW and the impact of screening mammography on breast cancer mortality, there is a paucity of evidence on interventional strategies to increase the participation of AAW in screening mammography. The limited evidence available suggests that interventional strategies that incorporate mass media communication, family and social support networks, and nurse navigation increased the number of AAW who participate in screening mammography. Citation Format: Shana O. Ntiri, Laundette P. Jones, Gonca Kocoglu, Emilie Ludeman, Paula Y. Rosenblatt. A systematic review of breast cancer screening strategies for African American women. [abstract]. In: Proceedings of the Ninth AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2016 Sep 25-28; Fort Lauderdale, FL. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2017;26(2 Suppl):Abstract nr C81.