Prevalence Of Breast Cancer Screening Research Articles

Changes in Breast Cancer Screening Prevalence in the US During the COVID-19 Pandemic, 2018-2022.

Annual mammography screening declined year-on-year during the COVID-19 pandemic through 2021. This study examined changes in 2022 compared to 2018 in the national prevalence of self-reported up-to-date mammography. Using 2018-2022 data from the Center for Disease Control and Prevention's (CDC) Behavioral Risk Factor Surveillance System (BRFSS), we assess relative changes defined as annual prevalence ratios (aPR) in the SR receipt of past-year and up-to-date (UTD) breast cancer screening (bi-annual mammography in women ages 50-74 years) during the third year of the COVID-19 pandemic overall and by sociodemographic characteristics. UTD BC screening declined for the first time since 2018 (2018 compared to 2022, from 78.7% to 76.6%; aPR, 0.97; 95% CI, 0.96-0.98), despite a small increase in past-year breast cancer screening from 2020 and 2022 (57.9% to 59.6%; aPR, 1.03; 95% CI, 1.01-1.05). This translated to 747,791 fewer women reporting UTD with recommended BC screening in 2022 vs. 2018. UTD BC screening declines between 2018-2022 were largest for American Indian/Alaska Native women (74.8% to 62.2%; aPR, 0.83; 95% CI, 0.74-0.93), women with less formal educational attainment (< high school: 73.1% to 65.5%; aPR, 0.9; 95% CI, 0.85-0.95), and women without a usual source of care (48% to 42.9%; aPR, 0.85; 95% CI, 0.78-0.92). Previously noted pandemic-related declines in past-year BC screening now reflect in women reporting being UTD, with the largest declines in AI/AN and lower SES women. Future studies should monitor screening prevalence in relation to BC diagnostic stage, overall and by sociodemographic groups.

Prevalence of Breast Cancer Screening in Asia: Systematic Review and Meta-Analysis.

Breast cancer is one of the leading causes of cancer-related mortality among women above 50 years of age. This systematic review and meta-analysis aimed at identifying the prevalence and trend of breast cancer screening among selected Asian countries. We searched three databases including, PubMed, Web of Science, and Scopus using our search terms. Two independent reviewers screened titles and abstracts applying the inclusion and exclusion criteria specified in the PROSPERO (registration ID: CRD42023401516) and any conflicts were resolved through discussion. Two independent reviewers and conflicts also completed the full-text screening, which was solved. Relevant information was extracted in an Excel sheet and random effects meta-analysis was performed to identify the pooled estimate of breast cancer screening in Asia using Stata 17. We identified 41 studies from 14 selected Asian countries reporting breast cancer screening rates from 2012-2023. The pooled estimate of four countries (China, Iran, Japan, and Korea) with more than three data points on clinical breast examination and mammographic screening showed a screening rate of 24% (95% CI: 0.20 - 0.27) and 18% (95% CI: (0.14 - 0.21) in the last ten years respectively. Most Asian countries do not have sufficient data on breast cancer screening due to a lack of nationally representative surveys or national-level cancer registries. Therefore, it is crucial to strengthen cancer control policies including breast cancer screening programs.

Abstract A155: Perceived interpersonal racism in healthcare settings and cancer screening

Abstract Introduction: Black and Hispanic people frequently report that perceptions of their race or ethnicity underlie racist and discriminatory experiences in many settings. In the healthcare field, these interpersonal racist experiences can severely impact the decision to receive care and the general health of the patient. Previous studies assessing the role of perceived racial discrimination in the healthcare setting and cancer screenings struggled with low sample sizes that precluded meaningful conclusions. Also, a methodological issue not considered in prior studies is the large degree of uncertainty reported by racialized groups in their assessment of perceived racism and its relevance to the measurement of this construct. In response to these data limitations and newly available nationally representative Behavioral Risk Factor Surveillance System data, we assessed the relationship of perceived racial discrimination in the healthcare setting associated with timely cancer screening across racial/ethnic groups. Methods: Data was collected from the 2022 Behavioral Risk Factor Surveillance System, which is a nationally representative state level population-based household survey with 28 states and the District of Columbia administering the optional modules assessing perceived racial discrimination. Perceived racism in healthcare was measured with the question: “Within the past 12 months when seeking health care, do you feel your experiences were worse than, the same as, or better than for people of other races?”. The outcomes were USPSTF recommendation concordant up-to-date colorectal, cervical, and breast cancer screening. Survey weighted logistic regression models adjusted for age, sex, education, and state estimated prevalence differences stratified by race/ethnicity. Results: Colorectal, cervical, and breast cancer screening were lower in White persons who reported worse (aPD vs. "better": -11.6%, -15.8%, -19.3%) and uncertain (don’t know) experiences of racial discrimination (aPD vs. "better": -7.4%, -4.1%, -5.0%). Among Black people, colorectal and cervical screening were only lower in those reporting uncertain experiences (aPD vs. "better": -10.8% and -12.0%). Among Hispanic persons, breast cancer screening prevalence was lowest in those who reported uncertain and worse racial discrimination (aPD vs. “better”: -12.4% and -15.9%). Conclusions: In this large generalizable sample, perceived racial discrimination in the healthcare setting was associated with cancer screening for both White and Black persons, but in different ways. Worse interpersonal racism in the healthcare setting was associated with lower cancer screening in White persons; but being uncertain relative to other race groups was largely associated with worse cancer screening among Black persons. Uncertainty in self-reported, racist experiences must be considered in institutional efforts to measure and address racism in healthcare settings. Citation Format: Jessica Star, Priti Bandi, Kilan Ashad-Bishop. Perceived interpersonal racism in healthcare settings and cancer screening [abstract]. In: Proceedings of the 17th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2024 Sep 21-24; Los Angeles, CA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2024;33(9 Suppl):Abstract nr A155.

Women’s empowerment and its influence on the uptake of breast cancer screening in Tanzania: an analysis of 2022 Tanzania demographic health survey data

BackgroundBreast cancer is the second most commonly diagnosed cancer worldwide, with a high mortality rate in developing countries, including sub-Saharan Africa. Screening is one way to ensure early detection and management of breast cancer, and it is influenced by several factors. Education and socio-economic status may also affect the utilization of breast cancer screening services as these impact decision-making. This study aimed to investigate women’s empowerment and its influence on the uptake of breast cancer screening among women in Tanzania.MethodsThis study utilized the 2022 Tanzania Demographic and Health Survey data, and included 4216 women aged 20 to 49 years. Women empowerment variables used include social independence, decision-making, ownership of assets, and attitude towards violence. Statistical Package for Social Sciences version 26 was used for data cleaning and analysis. Descriptive statistics and bivariate analysis were done, including a multivariate logistic regression to assess the level of association between independent variables with breast cancer screening.ResultsFindings indicate that the prevalence of breast cancer screening is 5.2%. Age, education level, literacy, ownership of assets, attitude towards violence, and decision making are associated with ever going for breast cancer screening. Women aged 45 to 49 years (AOR = 6.28, 95% CI = 6.27–6.28), those with secondary or higher education (AOR 1.1, 95% CI = 1.05–1.06), literate women (AOR = 1.13, 95% CI = 1.13–1.13), those who own a house (AOR = 3.08, 95% CI = 3.08–3.09), who jointly decide on their healthcare with partners on healthcare (AOR = 1.18, 95% CI = 1.18–1.19) had significantly higher odds of going for breast cancer screening.ConclusionWomen’s empowerment is significantly associated with the likelihood of engaging in breast cancer screening. Empowered women are more likely to undergo screening. Focus should be on empowering women through education, businesses, and community involvement. Country-specific interventions and breast cancer screening awareness campaigns should include empowerment initiatives to promote screening uptake.

Prevalence and associated factors of breast cancer screening among nuns in the Catholic Archdiocese of Nairobi.

breast cancer is a significant global challenge. The risk of breast cancer among nuns is high mainly due to the basis of nulliparity. Among the effective approaches to addressing breast cancer is early screening. However, there are concerns over the uptake of screening across all populations, including nuns. The objective of the study is to determine the prevalence and the associated factors of breast cancer screening among nuns in the Catholic Archdiocese of Nairobi. this research used the analytical cross-sectional design. A total of 384 nuns in the Catholic Archdiocese of Nairobi were recruited using a stratified sampling. Structured questionnaires were used to collect data. Chi-square and binary logistic regression were used to determine association between social-demographic factors and breast cancer screening. Statistical package for social sciences (SPSS version 26) was used for analysis. The level of significance was investigated at p<0.05. our findings revealed that the prevalence of breast cancer screening among nuns was 30.7%. The findings established that those who had knowledge on breast cancer screening (AOR=25.52, 95%CI: 8.87 - 73.45, p<0.001) and those who had congregational financial support (AOR=1.97, 95%CI: 1.68 - 5.74, p=0.021) were more likely to undergo breast cancer screening. Those who had hospital check-up for in more than six months prior to the study (AOR=0.001, 95%CI: 0.000 - 0.008, p<0.001) and those who never had a hospital check-up, (AOR=0.001, 95%CI: 0.000 - 0.006, p<0.001) were less likely to undergo breast cancer screening. the findings have shown low uptake of breast cancer screening amongst nuns in the Catholic Archdiocese in Nairobi. Knowledge on breast cancer screening access to congregational support and hospital check-up have been identified as key factors associated with breast cancer screening. Therefore, there is a need to create adequate awareness be created and the Catholic reverend sisters educated through aggressive education campaign programs so as to eliminate misconceptions relating to the topic. Also, to integrate free access to screening services in the government health institutions for nuns.

Exploring factors associated with breast cancer screening among women aged 15-49 years in Lesotho.

Introductionbreast cancer is associated with serious morbidity, low quality of life and mortality. Prevention through early screening remains one of the most optimal strategies against breast cancer. The primary objective of this analysis was to determine the prevalence of breast cancer screening using the clinical breast examination (CBE) and breast self-examination (BSE) methods among women aged 15-49 years, and the secondary objective was to explore demographic and socio-economic factors associated with clinical breast examination (CBE) and breast self-examination (BSE) breast cancer screening methods.Methodsthe study used Demographic Health Survey data collected in 2014. The study participants were Basotho women aged 15-49 years. STATA 17 was employed for developing logistic regressions and weighting for sampling probabilities and non-response. Complex sampling procedures were also considered during testing of statistical significance.Resultsvariables that were associated with significantly increased odds of having you had a breast cancer either self-examination or clinical test in last 12 months were: i) visiting a health centre in the past 12 months [odd ratio (OR): 1.21 (95% confidence interval [CI]: 1.02, p = 1.43); p = 0.025]; ii) completion of primary level education [1.27 ((1.10; 1.49); 0.001]; iii) being aware of breast cancer [2.18 (1.78;2.65); 0.001]; and iv) age [35-39 years: 1.40 (1.10;1.78);0.007]; while district of origin [Butha - Buthe: 0.63 (0.46; 0.85); 0.003] was significantly associated with decreased odds of the outcome.Conclusionour findings suggest that raising awareness about breast cancer is the most effective method of improving breast cancer screening among women in Lesotho.

Prevalence and determinants of breast cancer screening in four sub-Saharan African countries: a population-based study

ObjectivesBreast cancer is the most prevalent cancer and the second leading cause of cancer-related deaths among women after cervical cancer in much of sub-Saharan Africa. This study aims to examine...

The prevalence and predictive factors of breast cancer screening among older Ghanaian women

BackgroundBreast cancer cases are on the rise in Ghana, with older adult women being more at risk of the disease. However, there is a paucity of current studies on factors that predict breast cancer screening among older adult women using nationally representative data. The present study, therefore, addressed this gap by estimating the prevalence of and identifying the factors that predict breast cancer screening among older adult women in Ghana. MethodsWe used the cross-sectional survey dataset of the 2014/2015 (wave II) Study on global AGEing and adult health (SAGE). A complex survey design methodology was employed to estimate the prevalence of breast cancer screening and the descriptive statistics of the demographic characteristics of the respondents. We used the firth logistic regression for the bivariate and multivariate analysis. ResultsThe estimated breast cancer prevalence among older Ghanaian adult women was 4.5%. Older Ghanaian adult women who have screened for cervical cancer [AOR: 13.29; CI: 6.12, 28.84], had attained some primary education [AOR: 3.70; CI: 1.94, 7.07], junior secondary [AOR: 4.02; CI: 1.75, 9.21], senior secondary and higher [AOR: 4.57; CI: 2.15, 9.71], and have ever participated in a club meeting [AOR: 1.85; CI: 1.05, 3.24] were more likely to screen for breast cancer. ConclusionThe significant predictors of breast cancer screening were cervical cancer screening status, formal education, and participation in club meetings. Given that the prevalence of breast cancer screening among the older adult women in Ghana is low, we recommend that policies and programs dedicated to encouraging women to screen for breast cancer should aim at giving women the opportunity to obtain higher formal education, encouraging women to be actively involved in club meetings and to intensify efforts to encourage women to screen for breast cancer.

An analysis of the sociodemographic factors contributing to patient nonadherence to recommendations for screening mammograms.

e13077 Background: There were 2 million newly diagnosed cases of breast cancer in the United States during 2018 with 40,920 associated deaths1. The number of deaths has been decreasing over time due to effective breast cancer screening by mammogram. Routine mammograms lead to early recognition and treatment of breast cancer leading to an overall improvement in breast cancer outcomes. However, not all patients are adherent to screening mammogram schedules. The main aim of this study is to explore the current prevalence of breast cancer screening among women in the US. A secondary aim is to determine whether cancer screening is associated with identifiable sociodemographic determinants and cigarette smoking. Methods: Data were drawn from the Health Information National Trends Survey- (HINTS), a cross-sectional, nationally representative survey (N = 3,527) conducted in 2018. Responses from women aged 18-74 were used in this study. Descriptive analyses and chi-squared tests were conducted to estimate the prevalence of breast cancer screening by mammogram, as well as its association with certain sociodemographic characteristics and smoking status. Results: The survey sample included 1,722 women. The majority of the respondents were aged 45 years or older. A total of 5% of women had previously been diagnosed with breast cancer, most of them being between 65 and 74 years old. Overall, 22.1% of respondents reported that they had never had a mammogram. Breast cancer screening was significantly lower among young women aged 18 to 34 (76.0%), Hispanic (28.2%) and Asian (39.7%), and current smokers (24.6%). Conclusions: This study shows that there is a significant percentage of women in the US that do not adhere to screening recommendations for breast cancer. This study provides new and continuing evidence, regarding the profiles of women with poor adherence to these screening mammogram schedules. Overall, the findings from this study emphasize the importance of addressing racial and sociodemographic factors in an effort to improve screening mammogram adherence.

Accountable care organizations and the use of prostate cancer screening and breast cancer screening.

e18308 Background: Accountable Care Organizations (ACOs) were established under the Affordable Care Act as a new payment model intended to impose greater responsibility on all stakeholders for cost control and quality improvement. Preventive services are an ideal target to monitor the effectiveness of new health care delivery models. We sought to examine and compare the prevalence of breast cancer screening (BCa-S), and prostate cancer screening (PCa-S) between ACO and traditional Medicare beneficiaries. We hypothesized that the use of BCa-S is higher among beneficiaries attributed to an ACO, whereas the use of PCa-S, a non-recommended test, would be unaffected by ACO assignment. Methods: Using a random 20% sample of Medicare beneficiaries, we assessed BCa-S in women aged &lt; 75, (evidence-based cancer screening), and PCa-S in men &lt; 75 (non-recommended cancer screening) between January 1, 2013 and December 31, 2013 with appropriate exclusion criteria following the review of guideline recommendations. ACO coverage was ascertained from the quarterly assignment in the Shared Savings Program ACO Beneficiary-level file. Propensity-score weighting was performed to balance out patient and sociodemographic covariates. Results: Following propensity-score weighting, our final cohorts of ACO and traditional Medicare beneficiaries included 52,987 and 526,063 women for BCa-S; 86,936 and 814,221 men for PCa-S, respectively. The prevalence of screening in ACO vs. traditional Medicare were 35.0% vs. 25.2% for BCa-S, and 54.6% vs. 41.7% for PCa-S (all p &lt; 0.001) Conclusions: The ACO model appears to have a salutary effect on preventive service utilization. Our findings vis-à-vis PCa-S among ACOs are likely a reflection of improved health care access rather than vetted screening practices. There is hope that such nonrecommended screening will decrease if more ACOs are required to move towards a “two-sided” risk shared savings and loss model.

Accountable care organizations and the use of cancer screening.

Cancer preventive services, when used appropriately, result in improved health, better quality of life and decreased costs. For these reasons, cancer preventive services represent important priorities within the Affordable Care Act (ACA). Among the many provisions to improve access to preventive services the ACA introduced Accountable Care Organizations (ACOs) as trajectory to deliver coordinated, high-quality care. In order to evaluate this benchmark, we analyzed (in 2016/Boston) screening prevalence of breast cancer, a recommended screening test according to the United States Preventive Services Task Force (USPSTF), and prostate cancer, for which screening is no longer recommended by the USPSTF, among traditional Medicare beneficiaries and those enrolled in ACOs. We used propensity-score weighting to adjust for baseline confounders. We found that the prevalence of breast cancer screening (35.0% vs. 25.2%, p<0.001) and prostate cancer screening (54.6% vs. 41.7%, p<0.001) is higher among ACO enrollees. Our results suggest increased utilization of cancer preventive care within ACOs, regardless of whether the test is recommended or not. Better efforts may be needed within the ACO infrastructure to encourage recommended preventive care, but also penalize unnecessary use of low value services.

MP32-08 ACCOUNTABLE CARE ORGANIZATIONS AND THE USE OF PROSTATE CANCER SCREENING

You have accessJournal of UrologyGeneral & Epidemiological Trends & Socioeconomics: Value of Care: Cost and Outcomes Measures II1 Apr 2017MP32-08 ACCOUNTABLE CARE ORGANIZATIONS AND THE USE OF PROSTATE CANCER SCREENING Christian P. Meyer, Anna Krasnova, Jesse D. Sammon, Philipp Gild, Nicolas von Landenberg, Stuart R. Lipsitz, Joel S. Weissman, Felix K.H. Chun, Margit Fisch, Maxine Sun, and Quoc-Dien Trinh Christian P. MeyerChristian P. Meyer More articles by this author , Anna KrasnovaAnna Krasnova More articles by this author , Jesse D. SammonJesse D. Sammon More articles by this author , Philipp GildPhilipp Gild More articles by this author , Nicolas von LandenbergNicolas von Landenberg More articles by this author , Stuart R. LipsitzStuart R. Lipsitz More articles by this author , Joel S. WeissmanJoel S. Weissman More articles by this author , Felix K.H. ChunFelix K.H. Chun More articles by this author , Margit FischMargit Fisch More articles by this author , Maxine SunMaxine Sun More articles by this author , and Quoc-Dien TrinhQuoc-Dien Trinh More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2017.02.983AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Accountable Care Organizations (ACOs) were established under the Affordable Care Act as a new payment model intended to impose greater responsibility on all stakeholders for cost control and quality improvement. Preventive services are an ideal target to monitor the effectiveness of new health care delivery models. We sought to examine and compare the prevalence of breast cancer screening (BCa-S), and prostate cancer screening (PCa-S) between ACO and traditional Medicare beneficiaries. We hypothesized that the use of BCa-S is higher among beneficiaries attributed to an ACO, whereas the use of PCa-S, a non-recommended test, would be unaffected by ACO assignment. METHODS Using a random 20% sample of Medicare beneficiaries, we assessed BCa-S in those aged <75, (evidence-based cancer screening), and PCa-S in those <75 (non-recommended cancer screening) between January 1, 2013 and December 31, 2013 with appropriate exclusion criteria. ACO coverage was ascertained from the quarterly assignment in the Shared Savings Program ACO Beneficiary-level file. RESULTS Following propensity-score weighting, our final cohorts of ACO and traditional Medicare beneficiaries included, 52,987/526,063 women for BCa-S, and 86,936/814,221 men for PCa-S, respectively. The prevalence of screening in ACO vs. traditional Medicare were 35.0% vs. 25.2% for BCa-S, and 54.6% vs. 41.7% for PCa-S (all p<.001). CONCLUSIONS The ACO model appears to have a salutary effect on preventive service utilization. Our findings vis-a-vis PCa-S among ACOs are likely a reflection of improved health care access rather than vetted screening practices. There is hope that such nonrecommended screening will decrease if more ACOs are required to move towards a “two-sided” risk shared savings and loss model. © 2017FiguresReferencesRelatedDetails Volume 197Issue 4SApril 2017Page: e411 Advertisement Copyright & Permissions© 2017MetricsAuthor Information Christian P. Meyer More articles by this author Anna Krasnova More articles by this author Jesse D. Sammon More articles by this author Philipp Gild More articles by this author Nicolas von Landenberg More articles by this author Stuart R. Lipsitz More articles by this author Joel S. Weissman More articles by this author Felix K.H. Chun More articles by this author Margit Fisch More articles by this author Maxine Sun More articles by this author Quoc-Dien Trinh More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...

Abstract A34: Using a community-based breast health intervention to reduce structural barriers in accessing breast cancer screening services among underserved rural Latina and black women in Eastern North Carolina

Abstract Background: Although breast cancer mortality rates have been steadily decreasing over time, Black and Latina women continue to have the highest death rate and shortest survival of any racial and ethnic groups in the United States for breast cancers. Most scholars agree, however, that the major cause of this disparity is more likely to be diagnosed with late (vs. early) stage breast cancers that are less responsive to treatment. This disparity in cancer-stage-at-diagnosis reflects Black and Latina women's lower prevalence of breast cancer screening that could detect cancers at earlier, curable stages. Pitt and Edgecombe Counties, located in a rural disadvantaged part of Eastern North Carolina (ENC), maintain breast cancer disparities among its minority women as compared to their white counterparts. Breast cancer incidence among minority women is lower compared to white women for both counties, however the mortality rate for minority women is twice as high compared to their white counterparts (42.4 vs. 21.9 respectively) in Pitt county and slightly higher in Edgecombe county (37.3 vs. 36.7 respectively). Pitt County also has the highest breast cancer mortality rate among minority women and Edgecombe has the fifth highest in Eastern NC. Furthermore, minority women are diagnosed at later stages of the disease, with the rate of diagnosis at stage 4 being almost three times higher than white women in Pitt County and significantly higher in Edgecombe County. This community-based breast health intervention (The Pitt County Breast Wellness Initiative-Education) works to reduce these health disparities in breast cancer mortality through provision of education and navigation to early detection and access to screening for uninsured and underinsured Black and Latina women in Edgecombe and Pitt Counties in NC. Methods: The Pitt County Breast Wellness Initiative-Education provides culturally tailored breast cancer education and navigation to age-appropriate screening services for uninsured/underinsured Black and Latina women age 25 and older in Pitt and Edgecombe Counties, North Carolina. Using a lay health model (adapted from North Carolina Breast Cancer Screening Program Training Curriculum), we trained eight community members on breast health, breast cancer, and being an effective breast health educator. The education component includes a brief 10-minute presentation on breast health, breast cancer, and guidelines for age-appropriate breast cancer screening services. The navigation component includes assistance with the following: (1) Breast Health Assessment Tool and BCCCP applications, (2) scheduling appointments/accessing age-appropriate breast screening services, (3) interpretation, and (4) transportation. Since our program initiation in April 2015, we have educated 85 women and navigated 47 to age-appropriate breast cancer screening services in Pitt and Edgecombe counties. Results: Among the 47 navigated women to age-appropriate screening, 78% (n=37) were 40 years of age or older, 82% (n=39) reported being uninsured, 32% (n=15) reported no previous clinical breast exam, and 38% (n=18) reported no previous mammogram. Among those who reported a having a previous mammogram, many were 2 years or more over due for their yearly mammogram. We use pre-/post-surveys to determine an increase in knowledge and awareness regarding breast health, breast cancer, and guidelines for age-appropriate breast cancer screening services. Up-to-date results from program participants will be reported during the presentation. Conclusion: Specifically, using a LHA community-based model allows this program to serve as a cultural mediation between underserved communities in Pitt and Edgecombe counties and health care service systems and reduces structural barriers in accessing screening services and diagnostic follow-up. Strong collaborative community partnerships will streamline the process of accessing care in an effort to ensure seamless transition within the continuum of breast cancer care. Citation Format: Essie T. Torres, Alice R. Richman. Using a community-based breast health intervention to reduce structural barriers in accessing breast cancer screening services among underserved rural Latina and black women in Eastern North Carolina. [abstract]. In: Proceedings of the Eighth AACR Conference on The Science of Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; Nov 13-16, 2015; Atlanta, GA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2016;25(3 Suppl):Abstract nr A34.

Elimination of cost-sharing and receipt of screening for colorectal and breast cancer.

The aim of the cost-sharing provision of the Patient Protection and Affordable Care Act (ACA) was to reduce financial barriers for preventive services, including screening for colorectal cancer (CRC) and breast cancer (BC) among privately and Medicare-insured individuals. Whether the provision has affected CRC and BC screening prevalence is unknown. The current study investigated whether CRC and BC screening prevalence among privately and Medicare-insured adults by socioeconomic status (SES) changed before and after the ACA. Data obtained from the National Health Interview Survey pertaining to privately and Medicare-insured adults from 2008 (before the ACA) and 2013 (after the ACA) were used. There were 15,786 adults aged 50 to 75 years in the CRC screening analysis and 14,530 women aged ≥40 years in the BC screening analysis. Changes in guideline-recommended screening between 2008 and 2013 by SES were expressed as the prevalence difference (PD) and 95% confidence interval (95% CI) adjusted for demographics, insurance, income, education, body mass index, and having a usual provider. Overall, CRC screening prevalence increased from 57.3% to 61.2% between 2008 and 2013 (P<.001). Adjusted CRC screening prevalence during the corresponding period increased in low-income (PD, 5.9; 95% CI, 1.8 to 10.2), least-educated (PD, 7.2; 95% CI, 0.9 to 13.5), and Medicare-insured (PD, 6.2; 95% CI, 1.7 to 10.7) individuals, but not in high-income, most-educated, and privately insured respondents. BC screening remained unchanged overall (70.5% in 2008 vs 70.2% in 2013) and in the low SES groups. Increases in CRC screening prevalence between 2008 and 2013 were confined to respondents with low SES. These findings may in part reflect the ACA's removal of financial barriers.

Abstract P3-02-03: Breast cancer screening by women from BRCA1 &amp; BRCA2 mutation positive families

Abstract Purpose: Breast screening may detect breast cancer (BC) at an early stage but optimal screening depends on a woman’s level of risk and age. This study estimates the contemporary prevalence of BC screening by Australian women from families with a BRCA1/2 mutation identified by Family Cancer Clinics. Methods: Subjects were carriers and true non-carriers from families with a BRCA1/2 mutation enrolled in the nationwide kConFab cohort. They are followed up every 3 years with a questionnaire which includes use of breast ultrasound, mammography (MMG), magnetic resonance imaging (MRI) and clinical breast examination (CBE) over the previous 3 year period. Data from each woman’s most recent questionnaire (completed Oct 2009- March 2014) were used in the analysis. All knew their mutation result. Those who had risk-reducing mastectomy, previous cancer, were evaluated for benign breast disease, pregnant or breastfeeding or received their mutation result in the most recent follow-up round were excluded. Screening behaviour was categorized based on current national guidelines (see table). Associations with underscreening and overscreening were assessed using unconditional logistic regression to estimate odds ratios and 95% confidence intervals. Definitions of overscreening and underscreening for carriers &amp; true non-carriersGroupsOverscreening*Underscreening*CarriersBreast imaging (MMG +/- MRI) more often than annuallyBreast imaging less often than annually if age ≥30True non-carriersAge &amp;lt;40: any screening MMG; age ≥40: MMG more often than every 2 years OR any MRI or ultrasound screeningAge 50-70: MMG less often than every 2 years*Definitions derived from Cancer Australia Guidelines which do not recommend for or against CBE in any group and differ from US guidelines. Results: Of 372 eligible participants, there were 92 mutation carriers (42 BRCA1, 50 BRCA2) and 280 true non-carriers. 1% of carriers were overscreening, 86% were screening annually while 13% were underscreening. MRI, which is funded for mutation carriers aged 30-50 years, was used by only 52% (13/27) of carriers aged &amp;lt;50 years and by 7 carriers aged &amp;gt;50. Underscreening carriers were more likely to be single (OR=2.78, 95%CI=1.28-5.88, P=0.009) while those with a first degree cancer affected relative were less likely to underscreen (OR= 0.40, 0.19-0.85, P=0.017). CBE was undertaken by 79% of carriers at least yearly; 15% had no or irregular CBE. 115/280 (41%) non-carriers were overscreening, 55% were screening appropriately and 5% were underscreening. Underscreening non-carriers were more likely to be single (OR 3.85, 95%CI=1.00-14.9, P=0.05). Predictive of overscreening in non-carriers was having a cancer affected first degree relative (OR=2.92, 1.55-5.51, P=0.001). Non-carriers were less likely to utilise CBE (54%). Conclusion: Most mutation carriers in kConFab are having regular screening MMG, but MRI is underutilised even when funded. The reasons for low usage of MRI requires further research and is concerning given its increased sensitivity over MMG. Overscreening is common in true non-carriers of BRCA mutations. Family cancer history and marital status may predict inappropriate screening behaviour. Citation Format: Melanie Wuttke, Roger Milne, Prue Weideman, Sandra Picken, Charmaine Smith, Michael Friedlander, kConFab Investigators, Sue-Anne McLachlan, John L Hopper, Kelly-Anne Phillips. Breast cancer screening by women from BRCA1 &amp; BRCA2 mutation positive families [abstract]. In: Proceedings of the Thirty-Seventh Annual CTRC-AACR San Antonio Breast Cancer Symposium: 2014 Dec 9-13; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2015;75(9 Suppl):Abstract nr P3-02-03.

Clinical breast examination as the recommended breast cancer screening modality in a rural community in Malaysia; what are the factors that could enhance its uptake?

Breast cancer is the most common cause of deaths and the most frequently diagnosed cancer among women worldwide. This study aimed to determine the prevalence of breast cancer screening, specifically on clinical breast examination, and the predictors of its uptake among women in Malaysia. A cross-sectional study was carried out in five selected districts whereby women aged between 20 to 64 years old, from a total of 1000 households were interviewed. A total of 1192 women responded to the survey of which 53.3% reported had ever done clinical breast examination. Significant associations with clinical breast examination were noted for income and distance from the hospital. These factors should be considered in developing interventions aimed at promoting clinical breast examination. In particular, healthcare providers should be proactive in raising awareness about clinical breast examination among women in Malaysia.

Knowledge, Attitudes and Practices of Breast Cancer Screening Among Women in Jordan

Enhancing breast cancer screening in developing countries is pivotal in improving women's health. We aimed at describing knowledge of and perceived reasons for performing breast cancer screening. We interviewed 1,549 population-based randomly selected women. We found that women share limited knowledge about breast cancer screening. Few women performed screening for early detection purposes. The influence of physicians was the main reason for performing mammography. Prevalence of breast cancer screening might be enhanced by integrating screening into other medical services. Health agencies need to invite women for screening and educate them regarding the importance of screening in the absence of symptoms.

Cancer screening: inequalities ... in the data

Palencia et al were rightly concerned by inequalities in the use of cancer screening in 2002.(1) The discussion rightly began by an analysis of the strengths and weakness of the study but I am concerned by two points. The validity of the data could have been discussed, at least for France. For France, the prevalence of breast cancer screening can hardly be found in peer-reviewed journals but data exists.(http://www.invs.sante.fr/presse/2010/communiques/depistage_cancer_sein_060410/index.html) The French organized breast cancer screening programme achieved national coverage in 2004. Acceptance rate for this organized program increased from 40.2 % in 2004 49.3 % in 2006 and 52.5 % in 2008 which are far lower than the 79.4 cited by Palencia et al. Even in 2008 and 2009 only one territory, out a hundred, reached the 70% level (Haute-Vienne), whereas at the opposite Paris has the lowest rate (28.2 %). The second point is the relevance of the definition of screening prevalence (ie. mammography use in the previous 3years.). The benefit of screening programs is evidenced from randomized trials with durations reaching a decade. Evaluating the prevalence of screening by a cross-sectional analysis is misleading: it overestimates the quality of the programs and therefore the potential benefits. Last but not least, the publication in 2010 of raw data from 2002 underlines the urgent need for an European Cancer Observatory with adequate funding.(http://eu-cancer.iarc.fr/7-about-eco.html) This observatory muts allow to benchmark for reducing inequalities in cancer care among European countries.

Reliability of Self-Reported Breast Screening Information in a Survey of Lower Income Women

Background.Self-reported behavior is widely used to estimate the prevalence of breast cancer screening and to evaluate programs for promoting screening, but detailed studies of reliability have not previously been performed.Methods.Reliability was assessed by comparing responses to questions about screening behavior from repeat personal interviews of 382 women age 40 and older living in low-income census tracts of two Florida communities. Reliability was assessed using Pearson's correlation (r) and kappa (κ) coefficients.Results.Estimated reliabilities were κ = 0.38 for “ever had clinical breast examination,” κ = 0.82 for “ever had mammogram,” κ = 0.65 for “mammogram in past year,”r= 0.54 for “date of last mammogram,” andr= 0.72 for “number of mammograms.” The dates of last mammogram reported at the two interviews agreed within 1 month for 64% of the women, while the dates of last clinical breast examination agreed within 1 month for 50% of the women. Reliability of “ever had mammogram” was significantly related to demographic variables.Conclusions.Women reliably report ever having mammography, but information about timing and frequency has lower reliability. The results have implications for breast screening research because measurement error affects the precision of estimates and the sample sizes needed to detect program effects.

Breast Cancer Screening among Employed American Women.

From the 1990 National Health Interview Survey Health Promotion and Disease Prevention supplement, the authors estimated the 1990 baseline prevalence of breast cancer screening among employed U.S. women aged 50-70 years. Proportions of women screened for breast cancer were calculated by occupational category and demographic characteristics, and were compared with the Healthy People 2000 objective that 60% of women aged 50 and older have had mammography and a clinical breast examination within the preceding two years. The objective was exceeded for white-collar workers (61.8%) and workers with some college (64.1%), but was not met by any blue-collar/service workers (40.8%); or any workers with only a high school diploma (54.7%) or less than a high school diploma (38.5%). Identification of occupational categories and demographic subgroups among working women will be helpful to those planning breast cancer screening programs, in both the public and the private sectors.