Breast Cancer Screening Behaviors Among Women in Pennsylvania from 2000-2010

Abstract

BACKGROUND: Prevention is instrumental to decreasing the mortality and morbidity of cancer. Since 1991, the National Breast and Cervical Cancer Early Detection Program helps detect breast and cervical cancer early among uninsured and low income women.OBECTIVES: The study aims to examine how health insurance coverage and annual household income have impacted mammography utilization. Furthermore, temporal changes of late stage breast cancer rates in Pennsylvania will be analyzed to assess the impact of the statewide preventive initiatives.METHODS: A multivariate analysis was conducted of mammography screening rates in Pennsylvania from 2002 – 2010 for women aged 40 – 64. Multivariate analysis was also used to analyze breast cancer stage of diagnosis from 2000 – 2009 using Pennsylvania Cancer Registry to determine change over time.RESULTS: Compared to 2002, the rate of mammography utilization has steadily decreased. Mammography utilization is correlated significantly with health insurance and annual household income. Both individual and environmental factors appear associated with breast cancer diagnosis, with African American women having a higher odds of late stage cancer diagnosis, and the southeastern part of Pennsylvania having a higher rate.CONCLUSIONS: The study highlights the critical role of economic disadvantage on detection, and the importance of a program geared to low-income women, such as the HealthyWoman Project (HWP). The decreasing trend in late stage breast cancer diagnosis over time suggests a positive effect of HWP. Future studies should seek to better understand how factors influence the trajectory of breast cancer, and should investigate additional surveillance outcomes of the HWP.%%%%M.P.H., Public Health – Drexel University, 2012