Abstract P5-13-11: Characteristics of women under age 40 years served by organizations funded to conduct education and outreach to link medically underserved women with breast cancer screening services through the Avon breast health outreach program
Authors: Hallum-Montes RM , Opdyke KM , Aliaga M , Hurlbert M , Gates-Ferris K 
Published: August 2014

Abstract
Background
The Avon Breast Health Outreach Program (BHOP) supports community-based organizations to conduct education and outreach to link low-income and uninsured women to routine breast cancer screening. Women under age 40 with breast health issues may not be eligible for low-cost or free screening programs that target women age 40 and older.
Objective
Describe demographic and health characteristics of clients under age 40 served by Avon BHOP-funded organizations compared with clients of other age groups.
Methods
We analyzed CY2012 client intake data for females aged 20-75 years (N = 100,418). We conducted univariate and multivariate analysis of client demographics (race/ethnicity, annual household income, education, and geographic setting of client's residence) and health history (health insurance status, personal history of breast cancer, family history of breast cancer, prior breast biopsy, and prior mammogram). Results were stratified by age group.
Results
Overall, 5.7% (n = 5,719) of female clients were aged 20-39, 36.9% (n = 37,041) were aged 40-49, and 57.4% (57,658) were aged 50-75 years. A majority of clients (64.6%) identified as a racial and/or ethnic minority; this percentage was lowest among women under age 40 (58.8%), and highest among women aged 40-49 (69.2%). Overall, 78.4% of women reported an annual household income of $25,000 or less, with little variation across age groups. Women under age 40 were more likely to report having some college or an associate degree (27.2%) versus 21.3% of clients overall. Nearly two-thirds (64.5%) of clients reported no health insurance, with higher rates among women aged 20-39 (73.1%) and 40-49 (70.8%) compared with women aged 50 and older (59.6%). A majority of clients reported living in an urban setting (57.1%) or rural areas (31.4%); women under age 40 were more likely to report living in rural (40.8%) or frontier areas (4.6%). Current symptoms (lump, nipple discharge, rash, or unusual pain) were reported by 40.1% of women under age 40, compared with 12.0% of clients overall. Women aged 20-39 were less likely to have ever had a mammogram (34.8% versus 85.8% of all clients). However, white clients were almost twice as likely to have had a mammogram before the age of 40, even when controlling for breast symptoms and a family history of breast cancer.
Conclusion
Avon BHOP clients under age 40 were more likely to be white, to reside in rural areas, and to be uninsured despite higher levels of education. More than 40% of clients under age 40 reported current breast symptoms.
Discussion
Characteristics of Avon BHOP clients under age 40 are influenced by the location and target population of funded organizations. Low-income and uninsured women under age 40 may require specialized outreach and education to ensure timely access to breast cancer screening services.
Citation Information: Cancer Res 2013;73(24 Suppl): Abstract nr P5-13-11.