An update to a retrospective comparison of results between the National Breast and Cervical Cancer Early Detection Program and NCI cancer center based early detection program with evidenced based patient navigation and social work support.

Abstract

e18572 Background: The National Breast and Cervical Cancer Early Detection Program (NBCCEDP) through the CDC has provided uninsured women access to breast and cervical cancer screening/diagnostic services. The uninsured face obstacles which include fear, lack of access and trust in the system, financial and logistical barriers to accessing health care services (Natale-Pereira, et.al, 2011) Disparities in access to screening and diagnostic testing, cancer treatment and survivorship is well documented for medically vulnerable populations that impact stage of diagnosis and mortality (Guadagnolo, Dohan & Raich 2011). The Jefferson's program participates in the NBCCEDP program and uses other private resources which incorporate Social Work core competencies that provide assistance to address barriers. The program navigates along the continuum of cancer care (e.g, prevention, screening, treatment and survival). We have found in a comparative analysis that TJUH’s program has higher rates of diverse racial and ethnic participation of key medically underserved demographics than the National Program. Methods: TJUH's program employs a clinical model, Clinical Patient Navigation with a Licensed Clinical Social Worker operating from a strengths based framework to direct care with administrative support. The program utilizes best practices for working with the at risk population: translation services for the Limited English Proficient, appointment confirmation, transportation assistance and psychosocial support from initial point of contact through final diagnosis. Program staff coordinate internal and external referrals from multiple providers. Results: The study population includes 3144 participants who received breast and cervical cancer screening services through the program from 2012 through 2020. 13.9% were white, 41.7% were African-American, 24.5% were Asian and 19.1% Latinx participated in the program, Table. The age of the participants was slightly younger than the National program as well with 15% under 40, 46% between the ages of 40-49. Conclusions: TJUH’s program provides comprehensive psychosocial support to address barriers along the continuum of screening and diagnostic services leading with increased participation among at risk populations. This further reduces no show rates and participants being lost to follow up. TJUH’s program screens a larger proportion of African American and Asian and younger women compared to the NBCCED program. Additionally, we serviced a slightly younger population than the national program. TJUH’s program addresses health disparities and inequity in access to cancer screening services as shown by the data of the diversity of the participants.