Abstract P1-02-07: Adherence to breast cancer screening recommendations among underserved participants in an urban safety net mammography clinic
Authors: McClenathan MM , Lu J , Oppong BA , Adams-Campbell LL , Dash C 
Published: May 2019

Background: The Georgetown Lombardi Comprehensive Cancer Center's Capital Breast Care Center (CBCC) is a safety net mammography screening center that uses a community-based patient navigation program to provide underserved minority women guidelines-concordant mammography screening. Given that screening navigation is designed to eliminate some established barriers such as, access, transportation, and cost, we retrospectively examined patient adherence rates to regular (annual/biennial) mammography screening. We also investigated whether patient demographics are associated with adherence to breast cancer screening.

Methods: Data were derived from medical records of patients that received a baseline mammogram at CBCC in 2011 (n = 1,637) and were followed up for 4 years. Within the study time period of 2011-2015, patients were of age 40-74 and had not received a prior breast cancer diagnosis. 10 definitive cases of breast cancer were newly diagnosed in this population during the follow-up period and were excluded from the analysis. Adherence was then calculated based on the American College of Radiology (annual screening starting at 40) and the United States Preventive Services Task Force guidelines (biennial screening starting at 50).

Results: In 2011, the mean age of women screened at CBCC was 51.25 years with 45% being 40-50 years of age. CBCC has a predominantly minority population with 48% of the women identifying as Black/African American (AA) and 41% identifying as Hispanic in 2011. Over the 4 year follow up period, 41.11% of the patients screened in 2011 did not return for another screen. The adherence rate for annual screening in the 40-74 age group was 3.3% (3.0% in Black/AA; 4.2% in Hispanic) over the 4-year follow-up. The adherence rate for biennial screening among the 50-74-year-old age group was 21% overall (20% among Black/AA; 26% among Hispanics). Approximately 40% of the participants with baseline screenings in 2011 received at least one additional screening over the 4 year follow up but their mammography schedules were not guidelines concordant and they were labeled as “partially adherent” for this analysis.

Conclusion: While the number of partially adherent patients was consistent with previous population-based adherence studies, the proportion of non-adherent patients was higher compared with other population-based studies in primarily Non-Hispanic White populations. Our analysis highlights the importance of focusing on adherence to guidelines and not just mammography initiation in underserved minority populations through educational interventions targeted to patients and providers.

Citation Format: McClenathan MM, Lu J, Oppong BA, Adams-Campbell LL, Dash C. Adherence to breast cancer screening recommendations among underserved participants in an urban safety net mammography clinic [abstract]. In: Proceedings of the 2018 San Antonio Breast Cancer Symposium; 2018 Dec 4-8; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2019;79(4 Suppl):Abstract nr P1-02-07.