Abstract
Introduction: Uninsured women face increased barriers to obtaining age appropriate breast cancer screening. Despite the National Breast and Cervical Cancer Early Detection Program which provides breast cancer screening services to uninsured women below the federal poverty level, a majority of uninsured women still do not receive screenings. As a result, uninsured women are at risk of presenting with more advanced cancer. The purpose of this study is to identify risk factors, prevalence, and screening rates for breast cancer among uninsured women seen at free clinics.
Methods: A retrospective chart review was conducted to collect demographics, risk factors, breast cancer prevalence, and screening rates from medical records at ten free clinics in the Tampa Bay area of Florida from January 1st 2016-December 31st 2018. Uninsured women above the age of 45 were included in the study, in accordance with the American Cancer Society’s recommendation to begin screening women of average breast cancer risk by that age. Results: A total of 3721 women over the age of 45 were seen at free clinics during the study period. The mean age was 56.0 (SD=7.8). This sample was largely composed of Hispanic (n=1466, 47.6%) and unemployed (n=845, 46.2%) women. The mean (SD) BMI of patients was 30.5 (7.8). Of those with a recorded substance use history, 433 (18.7%) were current smokers and 454 (24.3%) were current alcohol consumers. Mammograms were documented for 838 (22.5%) of patients above the age of 45 years. The prevalence of breast cancer was 2.0% (n=73). Conclusions: Our study identifies a population of uninsured women who are at risk for breast cancer based on specific risk factors including age, BMI, smoking history, and alcohol use. Uninsured women seen at free clinics have suboptimal breast cancer screening rates. Our study population is largely comprised of Hispanic, unemployed, and low-income women who face additional healthcare barriers putting them at risk of advanced stage breast cancer. Our study increases awareness of an at-risk population, and increased efforts need to be made to provide uninsured women with age appropriate breast cancer screening in order to reduce morbidity and mortality.
Citation Format: Madeline MacDonald, Justin Swanson, Shreni Shah, Jhulianna Vivar, Ethan Song, Tanzila Ahsan, Rahul Mhaskar, Abu-Sayeef Mirza. Breast cancer risk factors, prevalence, and screening rates in uninsured women seen at free clinics [abstract]. In: Proceedings of the AACR Virtual Conference: Thirteenth AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2020 Oct 2-4. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2020;29(12 Suppl):Abstract nr PO-248.