ASPO Abstracts
Racial and ethnic differences in breast and cervical cancer screening among uninsured low-income women in Minnesota
Category: Cancer Health Disparities
Conference Year: 2021
Abstract Body:
Purpose
In the United States, disparities in cervical and breast cancer screening exist by race/ethnicity,
income and insurance. The National Breast and Cervical Cancer Early Detection Program
(NBCCEDP) offers screening for people who cannot otherwise afford it, but little is known about
racial/ethnic differences in service use. Here, we document racial/ethnic differences in utilization of
NBCCEDP services in Minnesota during 2012-2015.
Methods
Minnesota's NBCCEDP "Sage†offered screening to people who self-report as (a) 40-64 years old, (b)
250% ≤ federal poverty line, and (c) uninsured/underinsured. Sage maintains records of all women
screened through the program, including age and race/ethnicity (i.e. numerator). We defined the
eligible population for each race/ethnicity (i.e. denominator) using Small Area Health Insurance
Estimates for the state during 2012-2015 for women were eligible for Sage. For each group, we
estimated the rate of utilization of cervical cancer screening by dividing the number of women
screened at least once during 2012-2015 by the average number of eligible women per year. The rate
of utilization of breast cancer screening was estimated by dividing the average number of women
screened for per year by the average number of eligible women per year.
Results
An average of 31,450 women/year were eligible for screening through Sage during 2012-2015. Sage
screened 12,961 women for cervical cancer at least once and an average of 11,317 women/year for
breast cancer. Hispanic women had the highest rates of screening with 89.6% of those eligible
(3,917/4,371) receiving cervical cancer screening during the 3-year period and 74.0% (3,235/4,371)
receiving annual breast cancer screening. Meanwhile, only 28.5% (5,994/21,000) and 25.8%
(5,419/21,000) of eligible non-Hispanic white women were screened for cervical and breast cancer in
the study period, respectively.
Conclusions
Guideline-consistent screening is critical for reducing impact from cervical and breast cancers. In
contrast to national estimates, we found high levels of screening among Hispanic women suggesting
that Sage has been successful in reaching minority populations. Reasons for low utilization of
screening services among non-Hispanic white women need to be further explored.
Keywords: screening, breast cancer, cervical cancer, race, ethnicity