Abstract C06: Temporal changes in characteristics of women receiving screening mammograms at a community-based breast cancer screening center
Authors: Greenwald Holly S. , Dash Chiranjeev , Oppong Bridget , Coleman Tesha , Watkins Vivian , Adams-Campbell Lucile L. 
Published: May 2019

The American Cancer Society recommends annual mammography screening for women over 40 years old, however, screening uptake is lower among African American, Hispanic, and Asian Americans than Whites. Socioeconomic factors such as income, lack of insurance, low education level, and immigrant status are also associated with lower mammography screening rates. Among uninsured/under-insured and medically underserved populations, community clinics are important providers for breast cancer screening services. The Capital Breast Care Center (CBCC) of the Georgetown-Lombardi Comprehensive Cancer Center was established in 2004 to deliver breast and cervical cancer screening to all women in the District of Columbia (D.C.) metropolitan region regardless of ability to pay. We examined the characteristics of women presenting to CBCC for screening mammograms from 2010-2012 and investigated temporal changes in selected demographic and socioeconomic characteristics during this period.

Data was abstracted from the electronic medical records at CBCC and analyzed. Patient characteristics were described in frequencies and the statistical significance was determined using chi-square tests. From 2010 to 2012, 4,604 women were screened at CBCC. Patient volume increased each year, with a greater number of returning patients than each previous year. In 2010, 1428 women were seen, 46% of whom were new. In 2011 and 2012, 1581 and 1594 patients were seen, with 43% and 38% as new patients, respectively. About 40% of the women screened at CBCC each year were below the age of 50. The age distribution of the women remained relatively constant over the 3 year study period. African-American and Hispanic women accounted for about 90% of those screened at CBCC over the 3 year period. However, between 2010 and 2012, the racial/ethnic composition of the screenees shifted with a 9% decrease in the number of African-Americans and an increase of 6% among Latinas (P&lt;0.0001). A small increase in the number of Asian-American women was also noted (2%). Corresponding changes in the primary language spoken by the patients were also observed with the proportion of native English speakers decreasing and native Spanish speakers increasing by 6% from 2010 to 2012 (P &lt; 0.01). More than half of the women seen at CBCC were uninsured. The proportion of uninsured women screened at CBCC increased by 13% from 2010 (46%) to 2012 (59%), with corresponding declines in the proportion of screenees with private insurance (-3.52%), Medicaid (-5.49%), and Medicare (-1.98%) (P&lt;0.0001). 73% of the women screened between 2010 and 2012 had completed high school or higher education. Temporal changes in education levels of the participants were not evident in our data.

Reasons for the temporal changes in racial/ethnic composition and native language of the women seen at CBCC could be related to the demographic changes in the Washington D.C. metropolitan area and/or a demographic shift in the age distribution of Latinas thereby resulting in a greater percentage of them being eligible for mammograms. In addition, over the past three years, CBCC outreach efforts have increased in the Latino community with hiring of Spanish-speaking health educators and patient navigators. Results from our study underscore the importance of community-based clinics in increasing cancer screening uptake in un-/under-served communities.

Citation Format: Holly S. Greenwald, Chiranjeev Dash, Bridget Oppong, Tesha Coleman, Vivian Watkins, Lucile L. Adams-Campbell. Temporal changes in characteristics of women receiving screening mammograms at a community-based breast cancer screening center. [abstract]. In: Proceedings of the Twelfth Annual AACR International Conference on Frontiers in Cancer Prevention Research; 2013 Oct 27-30; National Harbor, MD. Philadelphia (PA): AACR; Can Prev Res 2013;6(11 Suppl): Abstract nr C06.