ASPO Abstracts
Financial Barriers to Cervical Cancer Screening: An Analysis of Low-income, Underscreened Women in North Carolina
Category: Financial Hardship Associated with Cancer
Conference Year: 2020
Abstract Body:
Purpose: Perceived cost has been documented as a significant barrier to cervical cancer screening,
particularly among medically under-served populations in which cervical cancer rates are highest. In
the following analysis, we aim to deepen the understanding of perceived financial barriers – including
direct medical, direct non-medical, and indirect barriers – among low-income, uninsured and
Medicaid-insured women who have not been screened for cervical cancer within the recommended
interval.
Methods: Data to be used in this analysis will be drawn from the baseline survey data of My Body,
My Test Phase 3 (MBMT-3). MBMT-3 is a two-arm randomized controlled trial examining the effect of
mailed HPV self-testing on cervical cancer screening among women rarely or never screened
(N=600). Our outcomes included perceived financial barriers to cervical cancer screening including
the following specific cost barriers: in-clinic screening, potential follow-up and treatment,
transportation, child care, missed pay due to time off work. We will report the percentage of study
participants reporting each type of cost barrier and subsequently conduct bivariate and multivariate
analyses to identify socio-demographic characteristics associated with each perceived barrier.
Results: Baseline data collection cleaning is currently being finalized; as such, analysis results are
not yet available.
Conclusions: We believe the results of this analysis will have important implications for future
strategies to improve cervical cancer screening uptake among low-income, under-screened
individuals. If findings show that participants report significant financial barriers to cervical cancer
screening, particularly as a result of transportation and childcare costs, HPV self-sampling kits
mailed to an individual’s home could potentially combat these barriers, thus increasing screening
uptake. In contrast, barriers related to in-clinic costs among uninsured women could be avoided via
Medicaid expansion or broader advertising for free screening programs, such as the North Carolina
Breast and Cervical Cancer Control Program (NC BCCCP).
Keywords: Key words: cervical cancer; cancer screening; financial barriers; under- screened populations; health disparities