ASPO Abstracts
Long-term mammography adherence among uninsured women enrolled in the Breast Screening and Patient Navigation program
Category: Cancer Health Disparities
Conference Year: 2021
Abstract Body:
Purpose of the study - The Breast Screening and Patient Navigation (BSPAN) Program provides access to no-cost
breast cancer screening services, financed by the National Breast and Cervical Cancer Early Detection Program,
to uninsured women in North Texas. Using data from the longitudinal BSPAN program, we aimed to determine
prevalence and correlates of (a) baseline adherence, and (b) longitudinal adherence to screening mammograms.
Methods – We analyzed electronic health record data for BSPAN participants ages 40-64 who had at least one
mammogram between 2012 and 2019. Outcomes were baseline adherence (women categorized as adherent if
they received their second mammogram 9-30 months after the index mammogram) and longitudinal adherence
(assessed only among women categorized as baseline adherent and defined as being adherent after 39 months
from the index mammogram). We used multivariable logistic regression and multivariable Cox proportional
hazards model to assess associations of socio-demographic and clinical characteristics with baseline and
longitudinal adherence, respectively.
Results - 19,292 women were included for analyses. Of these, 13,910 (72.1%) were baseline non-adherent and
5,382 (27.9%) were baseline adherent. Baseline adherence was more likely among women who were partnered,
lived in urban counties, preferred speaking Spanish, had poor reading ability, lived longer in U.S., were
asymptomatic, had prior PAP testing, and prior screening or diagnostic mammograms, compared to women who
were non-partnered, lived in rural counties, preferred speaking English, had good reading ability, lived in U.S. for
shorter duration, were symptomatic, had no prior PAP testing, and no prior screening or diagnostic mammograms,
respectively. Of the 5,382 women who were baseline adherent, 4,364 (81.1%) women demonstrated longitudinal
adherence. Correlates of longitudinal adherence were similar to those from baseline adherence.
Conclusions - Although the prevalence of baseline adherence was low (~28%), a large proportion of baseline
adherent women achieved longitudinal adherence (>80%). This highlights the importance of concentrating
resources and implementing navigation, especially during the second screen, thereby helping to achieve
adherence in the long-term.
Keywords: Mammography adherence, long-term, uninsured