Abstract B105: Potential barriers to mammography screening in Hispanic/Latino women living in the Northeast United States
Authors: Jones Beth A. , Doyle Margaret , Torres Aracelis , Genao Inginia , Kasl Stanislav V. , Soler-Vila Hosanna , Smith Marcella Nunez , Claus Elizabeth B. , Nappi Susan , Miranda Alejandra 
Published: June 2012

Background: Hispanic/Latinas (H/Ls) are more likely to be diagnosed with later staged breast cancer and to have poorer survival compared with White women. Mammography screening rates in H/Ls are lower than reported for Whites or African Americans. The goal of this study is to identify potential barriers to mammography screening in this understudied, at-risk population.

Methods: We report baseline results of 1083 community-based Hispanic/Latinas who have been enrolled in a prospective study of mammography screening. Hispanic/Latinas, ages 40–75, seeking care at primary care clinics in 4 cities with the largest Hispanic populations in CT and no prior history of breast cancer or biopsy, were eligible for inclusion in our study. 78% of women who were recruited participated in an hour-long telephone interview, generally conducted in Spanish (90%). We collected detailed information on sociodemographic, access to care, health knowledge and belief variables. A follow-up interview conducted a minimum of 26 months after the baseline interview and review of radiology records will provide prospective information of mammography screening. Univariate and bivariate analyses of the baseline data, reported here, identify potential barriers to mammography screening.

Results: Of the 1083 women recruited to date, 19% were born in the US, 54% in Puerto Rico, and 28% in other countries; almost 20% have been in the US for 10 years or less. Forty-four percent of women reported speaking and reading only Spanish and only 33% report that they speak English well or very well. These women were similar to the general population of H/Ls living in the Northeast in that they were of low socioeconomic status. Almost 50% of women reported an annual household income of $10,000 or less and 43% had less than a 12th grade education. The majority of women (78%) received some public insurance, primarily Medicaid, with 15.5% of our study population reporting no insurance coverage. Only 64% of women reported having a usual care provider, despite having been recruited from a primary care clinic. Less than half of the women (42%) reported their health as excellent or good, with a large proportion reporting significant comorbiity, particularly obesity and diabetes. Despite the large number of potential barriers, the self-reported history of mammography screening is somewhat higher than that reported for Hispanic/Latinas in national surveys at 74%, but comparable to the rates reported for Whites and African Americans.

Conclusions: Given that prospective measures of mammography screening have consistently shown significantly lower rates than retrospectively reported screening, we are likely to see lower screening rates once we have followed our cohort for a minimum of 26 months. The baseline data suggest that the community-based population of Hispanic/Latinas living in CT have significant barriers that may potentially impact the adherence to mammography screening guidelines. Findings from this investigation will be critical in informing cancer prevention strategies for this under-resourced population.

Citation Information: Cancer Epidemiol Biomarkers Prev 2011;20(10 Suppl):B105.