Abstract
Mobile health units are increasingly utilized to address barriers to mammography screening. Despite the existence of mobile mammography outreach throughout the US, there is a paucity of data describing the populations served by mobile units and the ability of these programs to reach underserved populations, address disparities, and report on outcomes of screening performance. To evaluate the association of variables associated with outcomes for women undergoing breast cancer screening and clinical evaluation on a mobile unit. Retrospective analysis of women undergoing mammography screening during the period 2008–2010. Logistic regression was fitted using generalized estimating equations to account for potential repeat annual visits to the mobile unit. In total, 4,543 mammograms and/or clinical breast exams were conducted on 3,923 women with a mean age of 54.6, 29 % of whom had either never been screened or had not had a screening in 5 years. Age < 50 years, lack of insurance, Hispanic ethnicity, current smoking, or having a family relative (<50 years of age) with a diagnosis of cancer were associated with increased odds of a suspicious mammogram finding (BIRADS 4,5,6). Thirty-one breast cancers were detected. The mobile outreach initiative successfully engaged many women who had not had a recent mammogram. Lack of insurance and current smoking were modifiable variables associated with abnormal screens requiring follow up.
Highlights
Many studies indicate that breast cancer health disparities exist among women of different races, ethnicities, socioeconomic statuses, geographic locations and age [1, 2]
Despite the existence of mobile mammography outreach throughout the US, there is a paucity of data describing the populations served by mobile units and the ability of these programs to reach underserved populations, address disparities, and report on outcomes of screening performance
According to the Centers for Disease Control and Prevention (CDC), National Program of Cancer Registries (NPCR) while the age-adjusted incidence rate of breast cancer among black females is slightly lower than that of white females, the mortality rates from breast cancer are significantly higher among black females [3, 4]
Summary
Many studies indicate that breast cancer health disparities exist among women of different races, ethnicities, socioeconomic statuses, geographic locations and age [1, 2]. Despite the existence of mobile mammography outreach throughout the US, there is a paucity of data describing the populations served by mobile units and the ability to reach underserved populations and address disparities [10,11,12,13,14,15]. To explore this issue, we sought to evaluate the demographics of the women screened on a mobile unit as part of a prevention program in Louisville, KY. Prevention program nurse navigators and physicians reviewed all results and made appropriate referrals for diagnostic follow up or specialty services for all suspected cancers
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