Abstract 4893: Who falls through the cracks?: Characteristics of women successfully and unsuccessfully navigated to breast cancer screening from the emergency department
Authors: Sara Heinert, John Hemphill, Gabrielle Gracias, Maya Iglesias, Jessica Kim, Hrithika Ravuri, Antonia Sames, Alexandra Sobocinski, Ana Natale-Pereira, Erin Muckey, Pamela Ohman-Strickland, Vince Silenzio, Jonathan McCoy, Amanda Esposito, Ethan Halm, Mary O'Dowd, Humaira Chaudhry
Journal: Cancer Research (2025)

Abstract Screening mammography has contributed to decreased breast cancer mortality, but screening disparities exist among racial/ethnic minority populations. Emergency departments (EDs) serve in a safety net capacity for underserved patients and are a novel place for cancer screening education and navigation. We implemented an intervention at two EDs in New Jersey where students recruited patients overdue for breast cancer screening and connected them to patient navigators. This analysis describes participants who were reached by a navigator to make a mammogram appointment versus those not reached, as well as women who attended their appointment versus not. Of 415 ED patients eligible for breast cancer screening (women 40-74 years old), 152 (37%) were eligible for the study (last mammogram &amp;gt;1 year ago), of which 101 agreed to participate. When contacted, 14 (14%) participants were reached and made a mammogram appointment. Women reached were more likely to: be in their 40s (71% vs. 49%), Hispanic (77% vs. 47%), Spanish-speaking (64% vs. 38%), not have private insurance (33% vs. 49%), and have Medicaid (22% vs. 10%) than women not reached. Nine women (9% total, 64% of those reached) attended a mammogram appointment. Women who attended their appointment had similar characteristics as women reached but were more likely to have a primary care provider (PCP) (78% vs 64%) and Medicaid (33% vs 22%) compared to all women who made an appointment. (See table.)Follow-up care is vital to an ED cancer screening intervention. Surprisingly, English speaking and patients with private insurance were less likely to be reached for a mammogram appointment. Patients without a PCP were less likely to attend their appointment. Adapting interventions to target women who “fall through the cracks” is imperative to improving breast cancer equity. More work is needed to strengthen the follow-up process for breast cancer screening for ED patients. Characteristics of Study Participants by Follow-Up Status % Attended Appointment (n=9) Made Appointment (n=14) Was Not Reached (n=87) All (n=101) Age Mean (SD) 48.7 (7.4) 47.8 (6.2) 51.1 (8.1) 50.6 (8.0) 40-49 years 67 71 49 53 50-59 years 22 21 31 29 60-69 years 11 7 19 17 70-74 years 0 0 1 1 Race/ Ethnicity Asian 0 0 6 5 Black 22 23 30 29 Hispanic 78 77 47 51 White 0 0 10 8 Other 0 0 7 6 Language English 33 36 60 56 Spanish 67 64 38 42 Other 0 0 2 2 Insurance Type Private 33 33 49 47 Medicaid 33 22 10 12 Medicare 0 0 8 7 No Insurance 33 33 27 28 Other 0 11 6 7 PCP (Y/N) Yes 78 64 52 54 Highest Level of Education Less than HS degree 38 42 38 38 HS degree or GED 38 33 40 39 Associate’s degree 13 8 5 5 Bachelor’s degree 13 17 10 11 Master’s degree 0 0 7 6 Citation Format: Sara Heinert, John Hemphill, Gabrielle Gracias, Maya Iglesias, Jessica Kim, Hrithika Ravuri, Antonia Sames, Alexandra Sobocinski, Ana Natale-Pereira, Erin Muckey, Pamela Ohman-Strickland, Vince Silenzio, Jonathan McCoy, Amanda Esposito, Ethan Halm, Mary O'Dowd, Humaira Chaudhry. Who falls through the cracks?: Characteristics of women successfully and unsuccessfully navigated to breast cancer screening from the emergency department [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2025; Part 1 (Regular Abstracts); 2025 Apr 25-30; Chicago, IL. Philadelphia (PA): AACR; Cancer Res 2025;85(8_Suppl_1):Abstract nr 4893.