Barriers to screening mammogram in southeastern Kentucky.

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.

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

Journal of Clinical Oncology ◽

10.1200/jco.2011.29.27_suppl.232 ◽

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.

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Breast cancer screening in patients with cancers other than breast.

Journal of Clinical Oncology ◽

10.1200/jco.2017.35.15_suppl.e13095 ◽

2017 ◽

Vol 35 (15_suppl) ◽

pp. e13095-e13095

Author(s):

Stephen M Maurer ◽

Robin Berton Leopold ◽

Alexander W Thomas ◽

Kyle Francis Concannon ◽

Alissa Dorothy Correll ◽

...

Keyword(s):

Breast Cancer ◽

Cancer Mortality ◽

Breast Biopsy ◽

Breast Cancer Mortality ◽

Screening Mammography ◽

Breast Cancers ◽

Screening Mammogram ◽

Female Patients ◽

Clear Cut ◽

Breast Malignancy

e13095 Background: Screening mammography can detect early breast cancers and reduce subsequent cancer mortality. However, there is a lack of consensus as to what should trigger screening discontinuation. This absence of clear-cut guidelines means that many patients with advanced malignancies continue screening despite unclear benefit. Methods: We performed a retrospective cohort study of female patients diagnosed with a non-breast malignancy to explore the incidence and effects of screening mammography. Female patients, who were diagnosed between 2007 and 2012 with a non-breast malignancy stage II or higher, were cross-referenced with the Vermont mammography screening logs from January 1, 2007 to September 30, 2014. Additional data was collected through chart reviews, in May 2016. Results: Of 1501 women, 398 (26%) who met the above criteria had a screening mammogram within first 5 years of their cancer diagnosis. Of these 398 women, 193 (48.5%) were alive without cancer, 132 (33.2%) had died, and 73 (18.3%) were alive with cancer at the time of chart review. Of those who died, 84 (63.6%) had a stage III or IV cancer. Eighteen (4.5%) had a breast biopsy following a suspicious screening mammogram, resulting in 13 (3.3%) benign diagnoses and 5 (1.3%) breast cancer diagnoses. No patient died of breast cancer. Conclusions: Female patients diagnosed with an advanced non-breast malignancy have a mortality risk that outweighs the known breast cancer mortality benefit from screening mammography. [Table: see text]

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Risk of noncompliance due to patient discomfort during screening mammogram

Journal of Clinical Oncology ◽

10.1200/jco.2009.27.15_suppl.1522 ◽

2009 ◽

Vol 27 (15_suppl) ◽

pp. 1522-1522

Author(s):

N. Mullai ◽

N. Murugesan ◽

L. Burton ◽

V. Goodin ◽

A. Stout

Keyword(s):

Breast Cancer ◽

Medical Center ◽

Hormone Replacement ◽

Breast Cancer Mortality ◽

Breast Cancer Incidence ◽

Screening Method ◽

Screening Methods ◽

Screening Mammogram ◽

Screening Mammograms ◽

Doctor's Office

1522 Background: There is enough evidence supporting the benefits of screening mammograms than any other screening procedure for the early detection of malignancy. Compliance to the screening method is very important to achieve this purpose. There is some concern about future trends in breast cancer mortality as a decline in rates of mammogram screening has been noticed. Pain during mammography has been recognized as a significant deterrent to breast screening. Hence this study was done to evaluate compliance in screening mammogram and to analyze major reasons for noncompliance. Methods: Randomly selected patients visiting the doctor's office for various reasons were asked about mammogram and their experience. Their responses were tabulated and analyzed statistically. Results: Out of 160 people questioned, 155 patients had mammogram regularly at 1–2 year interval and five patients did not. 50% of respondents were 51–70 years of age, 15% were 50 years or under, and 31% were over 70 years. Ninety patients (58%) reported their mammogram experience was unpleasant, causing pain and bruising. In spite of the discomforts reported, 132 (82.5%) patients said they would continue the screening as recommended. However, 28 patients (17.5%) indicated their intention not to get further mammograms based on their painful experience, unless the screening technology was improved. Conclusions: Breast cancer incidence after peaking in 1998 has decreased 9.8% since then with a 12% decline in women aged 50–60. The sharpest decline was noted from 2003 that could be due to the decrease in the hormone replacement therapy after the Women's Health Initiative report. However, it may also reflect some reduction in screening mammograms from 70% (in 2000) to 66% (in 2005) as estimated by National Health Interview Survey. Various causes were attributed for the decline in screening mammogram rate including the discomfort and pain caused by compression during film mammography. More than 1 in 6 patients refusing to undergo further screening is definitely a sign of concern. Better screening methods like patient controlled compression mammogram reported by Duke University Medical Center or other methods are worth investigating, to improve the compliance of the one of the effective preventive measures. No significant financial relationships to disclose.

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