Barriers to screening and treatment of breast cancer: Data analysis from Edgecombe County.

2011 ◽  
Vol 29 (27_suppl) ◽  
pp. 232-232
Author(s):  
M. E. Picton ◽  
B. Ramirez ◽  
D. Liles ◽  
T. R. Sastry ◽  
M. Petruzziello
Keyword(s):  
Breast Cancer ◽  
Low Income ◽  
Breast Cancer Mortality ◽  
Healthcare Providers ◽  
Health Department ◽  
Exact Test ◽  
Cancer Data ◽  
Barriers To Screening ◽  
Edgecombe County ◽  
Clinical Breast Examinations

232 Background: Edgecombe County in NC was described as the 3rd highest location breast cancer mortality according to the Susan G. Komen report (2007). The major issues detected were low education, lack of healthcare providers, and large numbers of uninsured individuals. Our analysis sought to further characterize the circumstances unique to this region and measures to improve mortality. Methods: Between October 2008 and January 2009, 493 surveys were conducted throughout the county. The surveyors randomly approached female residents of Edgecombe County who completed a questionnaire, which was analyzed for this study. Results: Of the total population 354 women were older than age 40. In this group 82.5% had recent mammograms and 79.8% clinical breast examinations. Also, 91.7% had a Primary Physician who recommended mammograms in 85% of the cases. Only 27.1% had family history of breast cancer and, of those, 86.2% were recommended mammograms. Most were educated (58.6%), had low income (76%) and health insurance (87.4%). Nearly equal numbers of Caucasians and African Americans completed the survey (50.6% vs. 47.6%). Just 8.1% had transportation problems and 3.6% were aware of free mammograms in the health department. Statistical analysis by the Fisher’s Exact Test evaluated the relationship between the likelihood of having a screening mammogram and different variables. Women who attended church were more likely to undergo mammograms (p=0.00054), as were women with insurance (p=0.024). Family histories of breast cancer, lack of transportation, low income or deficient education were not significant determinants to obtain a mammogram. A logistical regression model demonstrated that attendance to church and insurance were the two factors statistically significant in terms of obtaining a mammogram. Conclusions: The main issues identified by our analysis were low-income, low health care literacy and lack of awareness regarding breast cancer programs. Our results were discordant with some of the Susan Komen report data, particularly that the majority of participants had a mammogram. Transportation and religious beliefs were not barriers to screening of breast cancer.

Smoking and increased breast cancer risk in younger women in Appalachian Kentucky.

2012 ◽  
Vol 30 (15_suppl) ◽  
pp. e11097-e11097
Author(s):  
Indraneel Reddy ◽  
Anjali Shankar ◽  
Priya Mallikarjun ◽  
Nicola Jabbour ◽  
Mark Dignan
Keyword(s):  
Breast Cancer ◽  
Smoking Status ◽  
Adult Population ◽  
Current Smoker ◽  
The State ◽  
Age At Diagnosis ◽  
Breast Cancers ◽  
Exact Test ◽  
Cancer Data ◽  
Appalachian Kentucky

e11097 Background: Smoking rates in Kentucky are among the highest in the US. Data from the Centers for Disease Control and Prevention for 2011 showed that in Kentucky 25.2% of the adult population are current smokers compared to 18.4% nationwide. In addition, smoking rates in the Appalachian region are substantially higher than the state rate. Breast cancer rates are also elevated in Appalachian Kentucky, with data from the Kentucky State Cancer Registry for 2004-2008 showing an incidence rate of 67.3 per 100,000 in Appalachia compared to 65.6 per 100,000 for the state. Our objective was to evaluate the association of smoking and breast cancer among women in Appalachian Kentucky. Methods: We reviewed all the breast cancer data from a large community hospital serving the Appalachian areas of Kentucky. Data were collected from the hospital tumor registry for the period 1996-2005 and included demographic characteristics and smoking status, in addition to information about the breast cancer. No personal identifiers were collected. Breast cancers were coded as invasive or non-invasive and smoking status was coded as current smoker, non-smoker or unknown. Results: Data from records of 392 patients were included in the analyses. Over 90% of the breast cancers in the 392 were invasive. Age at diagnosis ranged from 24 to 92 and the mean was 59.9 years (standard deviation= 13.5. 21.2% of the records indicated a family history of breast cancer. Of the 392 patients, 162 (41.3%) were smokers. Analysis of the data by age at diagnosis showed that of the 120 women diagnosed with breast cancer at age less than 65, 46.5% were smokers, compared to 31.3% of those age 65 or older (p=.005, Fisher’s Exact Test). Conclusions: The risk of breast cancer in women under age 65 appears to be associated with smoking in this population. Additional research is needed to more fully explore this association.

Effects on histologic subgroup, race, and BMI in 2,110 breast cancer patient: Results from single institution in Georgia.

2019 ◽  
Vol 37 (15_suppl) ◽  
pp. e13112-e13112
Author(s):  
Ricardo H. Alvarez ◽  
Rebecca Rollins ◽  
Joe Ensor ◽  
Daniel W. Nixon ◽  
Jonathan Ramey ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Cancer Biology ◽  
Breast Cancer Mortality ◽  
Population Based ◽  
Rank Test ◽  
Racial Groups ◽  
Single Institution ◽  
Exact Test ◽  
Fisher's Exact Test ◽  
Fisher’S Exact Test

e13112 Background: Disparities in breast cancer (BC) care still clearly exist among Whites (W) and African-Americans (AA) racial groups. These disparities resulting in higher mortality among AA compared to W. The objective of this analysis was to estimate the prevalence of BC subtypes in a population-based sample of BC cases, collected in a Breast Cancer Database (BCD) and to examine correlations with demographic and clinicopathologic variables and patient survival. Methods: retrospective analysis of patients registered at BCD was performed. Pts with BC were analyzed for differences in survival based on histologic subgroup (HS), race and BMI. Median Kaplan Meyer estimate for potential follow-up was 13.1 months with 95% CI (10.6, 15.0). Univariate and multivariate analysis were used to identify factors associated with demographic and cancer biology variables. Results: A total of 2,110 patients were registered at BCD and were available for this analysis.The median age at diagnosis was 50.8 years with 95% CI of (50.2, 51.0). 50% were W and 46.6% were AA. HS were classified by immunohistochemistry CLIA central lab, ER+ 61.1%, HER2+ 21.8% and TNBC 17%.Fisher’s exact test showed statistically difference in HS distribution among the races (p < 0.0001); 25% and 11.7% TNBC, for AA and W, respectively. The mean BMI was 29.0 with 95% CI of (29.6, 30.2). BMI characteristics were obese 47.2%, overweight 28.6% and normal 22.2%. Fisher’s exact test showed statistically difference in BMI distribution among the races, 57% and 39% obesity, for AA and W, respectively (p < 0.0001). Log-rank test showed that 2-years OS is worse for TNBC (48%), than for ER+ (72%) and HER2+ (75%). In the multivariable model AA survival was statistically inferior than for W ( p= 0.0094). Cox proportional hazard model was constructed to assess the effect of age, BMI, race and HS (Table). Conclusions: This single institution analysis demonstrated a statistically differences between TNBC, AA, and abnormal BMI as poor prognostic factors in BC pts impacting OS. Further research should investigate how to improve care for AA women who are at higher risk for breast cancer mortality. [Table: see text]

scholarly journals The impact of a national program to provide free mammograms to low-income, uninsured women on breast cancer mortality rates

Cancer ◽  
2010 ◽  
Vol 116 (19) ◽  
pp. 4456-4462 ◽  
Author(s):  
David H. Howard ◽  
Donatus U. Ekwueme ◽  
James G. Gardner ◽  
Florence K. Tangka ◽  
Chunyu Li ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Low Income ◽  
Cancer Mortality ◽  
Breast Cancer Mortality ◽  
Mortality Rates ◽  
National Program ◽  
The Impact

scholarly journals “Talk About Cancer and Build Healthy Communities”: How Visuals Are Starting the Conversation About Breast Cancer Within African-American Communities

2020 ◽  
pp. 0272684X2094207
Author(s):  
Brooks Yelton ◽  
Heather M. Brandt ◽  
Swann Arp Adams ◽  
John R. Ureda ◽  
Jamie R. Lead ◽  
...  
Keyword(s):  
Breast Cancer ◽  
African American ◽  
Breast Cancer Mortality ◽  
Healthcare Providers ◽  
Cancer Information ◽  
Community Members ◽  
Visual Tool ◽  
Rural And Urban ◽  
Priority Populations ◽  
Source Reliability

African-American (AA) women are at higher risk of breast cancer mortality than women of other races. Factors influencing breast cancer risk, including exogenous environmental exposures, and debate around timing of exposure and dose-response relationship, can cause misunderstanding. Collaboration with priority populations encourages culturally relevant health messaging that imparts source reliability, influences message adoption, and improves understanding. Through six focus groups with AA individuals in rural and urban counties in the southeastern United States, this study used a community-engaged participatory approach to design an innovative visual tool for disseminating breast cancer information. Results demonstrated that participants were generally aware of environmental breast cancer risks and were willing to share new knowledge with families and community members. Recommended communication channels included pastors, healthcare providers, social media, and the Internet. Participants agreed that a collaboratively designed visual tool serves as a tangible, focused “conversation starter” to promote community prevention and education efforts.

Barriers to screening mammogram in southeastern Kentucky.

2014 ◽  
Vol 32 (26_suppl) ◽  
pp. 6-6
Author(s):  
Raymond Elsoueidi ◽  
Eyob Adane ◽  
Elie Maroun Richa
Keyword(s):  
Breast Cancer ◽  
Urban Areas ◽  
Healthcare Access ◽  
Breast Cancer Mortality ◽  
Care Physician ◽  
Dramatic Improvement ◽  
Local Churches ◽  
Screening Mammogram ◽  
Barriers To Screening ◽  
Barriers To Healthcare Access

6 Background: Breast cancer is the most common cancer in females. Screening mammogram has been linked to reduced breast cancer mortality through early detection and effective treatment following diagnosis. Despite the dramatic improvement in the use of screening mammogram nationwide, disparities still exist. Southeastern Kentucky has multiple barriers to healthcare access with screening mammogram rates of around 63% compared to 80% in urban areas. We performed this observational study to identify the barriers to screening mammogram in southeastern Kentucky. Methods: Questionnaires were distributed to women age 40 and older at local churches and hospitals in 10 counties of southeastern Kentucky. Questions included age, healthcare coverage, having a primary care physician, having a mammogram within the past 2 years, and reasons for not having a mammogram. Results: Among the 328 females that participated in the survey, 36.3% did not have a mammogram. The median age (interquartile range) was 57 (50 to 63) and there were no difference between respondents with a mammogram and those without. Among the 119 females without a mammogram, the most common reasons for not having a mammogram were as follows: no interest in having a mammogram (33%), not being referred by their primary physician (24%), lack of time (12%), and lack of insurance (11%). Other responses included old age (5%), fear of pain of the procedure (3%), lack of knowledge/information (3%), and lack of transportation (2%). Seven percent did not provide reasons. Conclusions: Based on this survey, the most common barrier to obtaining a screening mammogram is patient perception, as evidenced by lack of interest, time, and knowledge/information, followed by failure of referral by physicians. Interventions that target these barriers will likely improve adherence to screening mammogram.

scholarly journals Impact of Community-Based Clinical Breast Examinations in Botswana

2021 ◽  
pp. 17-26
Author(s):  
Michael Dykstra ◽  
Brighid Malone ◽  
Onica Lekuntwane ◽  
Jason Efstathiou ◽  
Virginia Letsatsi ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Cancer Diagnosis ◽  
Screening Program ◽  
Breast Cancer Mortality ◽  
Clinical Breast Examination ◽  
Breast Cancer Diagnosis ◽  
Community Based ◽  
Middle Income ◽  
Clinical Breast ◽  
Clinical Breast Examinations

PURPOSE We evaluated a clinical breast examination (CBE) screening program to determine the prevalence of breast abnormalities, number examined per cancer diagnosis, and clinical resources required for these diagnoses in a middle-income African setting. METHODS We performed a retrospective review of a CBE screening program (2015-2018) by Journey of Hope Botswana, a Botswana-based nongovernmental organization (NGO). Symptomatic and asymptomatic women were invited to attend. Screening events were held in communities throughout rural and periurban Botswana, with CBEs performed by volunteer nurses. Individuals who screened positive were referred to a private tertiary facility and were followed by the NGO. Data were obtained from NGO records. RESULTS Of 6,120 screened women (50 men excluded), 452 (7.4%) presented with a symptom and 357 (5.83%) were referred for further evaluation; 257 ultrasounds, 100 fine-needle aspirations (FNAs), 58 mammograms, and 31 biopsies were performed. In total, 6,031 were exonerated from cancer, 78 were lost to follow-up (67 for ≤ 50 years and 11 for > 50 years), and 11 were diagnosed with cancer (five for 41-50 years and six for > 50 years, 10 presented with symptoms). Overall breast cancer prevalence was calculated to be 18/10,000 (95% CI, 8 to 29/10,000). The number of women examined per breast cancer diagnosis was 237 (95% CI, 126 to 1910) for women of age 41-50 years and 196 (95% CI, 109 to 977) for women of age > 50 years. Median time to diagnosis for all women was 17.5 [1 to 32.5] days. CBE-detected tumors were not different than tumors presenting through standard care. CONCLUSION In a previously unscreened population, yield from community-based CBE screening was high, particularly among symptomatic women, and required modest diagnostic resources. This strategy has potential to reduce breast cancer mortality.

Repeat Mammography Screening among Low-Income and Minority Women: A Qualitative Study

2005 ◽  
Vol 12 (4_suppl) ◽  
pp. 77-83 ◽  
Author(s):  
Maria E. Fernandez ◽  
Richard C. Palmer ◽  
Cindy A. Leong-Wu
Keyword(s):  
Breast Cancer ◽  
African American ◽  
Low Income ◽  
Mammography Screening ◽  
Hispanic Women ◽  
Breast Cancer Mortality ◽  
Minority Women ◽  
Future Research ◽  
Enabling Factors ◽  
Factors Associated

Regular mammography screening can reduce breast cancer mortality, yet low-income African American and Hispanic women underutilize mammography screening and are often diagnosed at a later stage, resulting in increased mortality. We used qualitative research methods to identify factors influencing regular breast cancer screening among African American and Hispanic women. Predisposing factors (including fear of mastectomy and lack of knowledge), enabling factors (including cost and social support) and a reinforcing factor were identified and categorized utilizing the PRECEDE framework. The study identified factors associated with the decision to complete regular mammography screening, and examined differences between African American and Hispanic women who participated in the interviews. Future research should seek to better understand the influence of family/friends, risk perception, and fatalistic beliefs on the decision to obtain regular mammograms.

scholarly journals Adjuvant Hormonal Therapy Use Among Insured, Low-Income Women With Breast Cancer

2009 ◽  
Vol 27 (21) ◽  
pp. 3445-3451 ◽  
Author(s):  
Gretchen Kimmick ◽  
Roger Anderson ◽  
Fabian Camacho ◽  
Monali Bhosle ◽  
Wenke Hwang ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Hormonal Therapy ◽  
Low Income ◽  
Hormone Receptor ◽  
Breast Cancer Mortality ◽  
Medication Possession Ratio ◽  
Adjuvant Radiation ◽  
Adjuvant Hormonal Therapy ◽  
Data Set ◽  
Risk Of Cancer

Purpose Use of adjuvant hormonal therapy, which significantly decreases breast cancer mortality, has not been well described among poor women, who are at higher risk of cancer-related death. Here we explore use of adjuvant hormonal therapy in an insured, low-income population. Methods A North Carolina Cancer Registry–Medicaid linked data set was used. Women with hormone receptor–positive or unknown, nonmetastatic breast cancer, diagnosed between 1998 and 2002, were included. Main outcomes were (1) prescription fill within 1 year of diagnosis, (2) adherence (medication possession ratio), and (3) persistence (absence of a 90-day gap in prescription fills over 12 months). Results The population consisted of 1,491 women (mean age, 67 years). Sixty-four percent filled prescriptions. Predictors of prescription fill included the following: older age (odds ratio [OR], 1.01; P = .017), greater number of prescription medications (OR, 1.06; P < .001), nonmarried status (OR, 1.82; P = .001), higher stage (OR, 1.83; P < .001), positive hormone receptor status (positive v unknown, OR, 1.98; P < .001), not receiving adjuvant chemotherapy (OR, 1.74; P = .001), receipt of adjuvant radiation (OR, 1.55; P = .004), and treatment in a small hospital (OR, 1.49; P = .024). Adherence and persistence rates were 60% and 80%, respectively. Nonmarried status predicted greater adherence (OR, 1.90; P = .006) and persistence (OR, 1.75; P = .031). Conclusion Prescription fill, adherence, and persistence to adjuvant hormonal therapy among socioeconomically disadvantaged women are low. Improving use of adjuvant hormonal therapy may lead to lower breast cancer–specific mortality in this population.

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