Promoting cervical cancer screening services through a breast cancer screening program

B67

Background: The Tennessee Breast and Cervical Cancer Screening Program (TBCSP), provides free breast and cervical cancer screening to women who are uninsured or underinsured. As a result, screening rates have significantly improved in all racial and ethnic groups over the past 10 years. However, there remains underutilization of the TBCSP, particularly by women who are never or rarely screened for cervical cancer. Mammograms in May (MIM) is a successful annual breast cancer screening program in Nashville, TN that offers no-cost screening mammograms at Nashville General Hospital. The Center for Women’s Health at Meharry is one of only two health clinics in Davidson County that provides cervical cancer screening and follow-up for the TBCSP. We hypothesized that inquiring about recent Pap test screening during the MIM visit would help identify women who had not undergone recent cervical cancer screening. Methods: When women arrived for mammography examinations they were asked if they had received a Pap test within the past 3 years. Women who had not were referred for services and eligible women were enrolled in the TBCSP. Results: Four hundred and twenty-nine screening mammograms were performed as a result of the MIM program in 2007. We identified one hundred and eighty-six (43%) women who had not had a Pap test in greater than 3 years. Ninety-three (22%) women were eligible for enrollment in the TBCSP and were scheduled to be seen at the Center for Women’s Health at Meharry. To date, 57/93 (61%) Pap tests have been completed. We have identified fewer than 5% abnormal Pap tests and have not diagnosed any cancers. Conclusion: All women who sought no cost mammography services through the MIM program were asked if they had undergone recent cervical cancer screening with Pap tests. Almost half of the women undergoing breast cancer screening examinations had not had a recent Pap test. Furthermore, one-fifth of the women were eligible for enrollment in the TBCSP, indicating their status as uninsured or underinsured. We made certain that Pap test services were readily available through close collaboration between the Center for Women’s Health at Meharry and the TBCSP. As a result, the appointment show rate was greater than 50%. These results are preliminary, but suggest further study is warranted to explore the approach of using breast cancer screening programs as a method of promoting utilization of cervical cancer screening services and engaging women in a health care system.