Abstract B81: Results of a randomized trial to increase breast and cervical cancer screening among Hispanic women that reside along the U.S.- Mexico border

Breast cancer is the most common neoplasm among Hispanic women in terms of incidence and mortality. Despite a lower incidence and mortality compared to non-Hispanic White women, breast tumors in Hispanics are more likely to present at a larger size and more advanced stage disease. Cervical cancer has a higher incidence and mortality among Hispanic women compared to non-Hispanic White women. The purpose of this study was to assess the effectiveness of a promotora-administered educational intervention to promote breast and cervical cancer screening among postreproductive age, medically-underserved Hispanic women living in a predominantly rural county along the U.S.-Mexico border. All interviews and subject contacts were carried out by female, bilingual community health workers (promotoras) from the same communities that were being surveyed. Women age 50 or older were eligible to participate in this study. A total of 1,255 contacts were made in order to identify 639 eligible individuals, and enroll 504 participants for the baseline survey. Of those, 393 subjects chose to participate in the follow-up portion of the study. Women were randomly assigned into one of two groups, educational-intervention or usual care. Proportions of subjects utilizing breast and cervical cancer screening services were calculated. The primary outcomes were self-reported mammogram and Pap smear screening. Logistic regression analysis was used to compute odds ratios for comparisons between intervention and control groups. Sixty seven percent of the women that participated in the promotora-intervention had a pap smear within the last year, compared to 51% from the usual care arm. In addition, 77% of the women that participated in the promotora-intervention had a mammogram within the last year, compared to 63% from the usual care arm. The intervention group was 2.0 times more likely to have had a mammogram within 1 year as compared to the usual care group (p=0.004). Also, the intervention group was 1.9 times more likely to have had a Pap smear within 1 year as compared to the usual care group (p=0.002). We found that Hispanic women living along U.S.-Mexican Border that participated in the intervention were more likely to have participated in breast and cervical cancer screening programs than those who were in the usual care arm. A promotora-based educational intervention can be used to increase breast and cervical cancer screening compliance among Hispanic women.