Breast cancer screening of underserved women in the USA: results from the National Breast and Cervical Cancer Early Detection Program, 1998-2012

• Type of Material: Article
• Authors: David Howard, Emory University; Florence Tangka, Emory University; Janet Royalty, Emory University; Lucinda P. Dalzell, US Census Bureau; Jacqueline Miller, Emory University; Brett O'Hara, US Census Bureau; Kristy Joseph, Emory University; Kristy Kenney, Emory University; Gery Guy, Emory University; Ingrid J. Hall, Emory University
• Language: English
• Date: 2015-05-01
• Publisher: Springer Verlag (Germany)
• Publication Version: Author Accepted Manuscript (After Peer Review)
• Copyright Statement: © 2015, Springer International Publishing Switzerland.
• Final Published Version (URL): http://dx.doi.org/10.1007/s10552-015-0553-0
• Title of Journal or Parent Work: Cancer Causes and Control
• ISSN: 0957-5243
• Volume: 26
• Issue: 5
• Start Page: 657
• End Page: 668
• Grant/Funding Information: Dr. Howard received support for this research from the Centers for Disease Control and Prevention (12IPA1203126).
• Keywords: Public, Environmental & Occupational Health; Health services accessibility; Life Sciences & Biomedicine; SERVICES TASK-FORCE; Mammography; MAMMOGRAPHY; Science & Technology; Medically uninsured; Early detection of cancer; Oncology; UNITED-STATES
• Research Categories: Health Sciences, Oncology; Health Sciences, Public Health; Health Sciences, Health Care Management

Abstract

Objective: To describe the number and proportion of eligible women receiving mammograms funded by the National Breast and Cervical Cancer Early Detection Program (NBCCEDP). Methods: Low-income, uninsured, and underinsured women aged 40–64 are eligible for mammography screening through the NBCCEDP. We used data from the NBCCEDP, the Current Population Survey, and Medical Expenditure Panel Survey to describe the number and proportion of women screened by the NBCCEDP and overall. Results: In 2011 and 2012, the NBCCEDP screened 549,043 women aged 40–64, an estimated 10.6 % (90 % confidence interval [CI] 10.4–10.9 %) of the eligible population. We estimate that 30.6 % (90 % CI 26.4–34.8 %) of eligible women aged 40–64 were screened outside the NBCCEDP, and 58.8 % (90 % CI 54.6–63.0 %) were not screened. The proportion of eligible women screened by the NBCCEDP varied across states, with an estimated range of 3.2 % (90 % CI 2.9–3.5 %) to 52.8 % (90 % CI 36.1–69.6 %) and a median of 13.7 % (90 % CI 11.0–16.4 %). The estimated proportion of eligible women aged 40–64 who received mammograms through the NBCCEDP was relatively constant over time, 11.1 % (90 % CI 10.2–11.9 %) in 1998–1999 and 10.6 % (90 % CI 10.4–11.9 %) in 2011–2012 (p = 0.23), even as the number of women screened increased from 343,692 to 549,043. Conclusions: Although the NBCCEDP provided screening services to over a half million low-income uninsured women for mammography, it served a small percentage of those eligible. The majority of low-income, uninsured women were not screened.