A Process Evaluation For A Comprehensive Breast Cancer Screening Intervention

Although survival rates of breast cancer are improving, it is occurring at a slower rate for minorities (O’Keefe et al., 2015). Recommendations on when to begin mammography screenings vary slightly with greatest consensus for women with average risk to begin annual screening at 40-years-old. Fewer minority women adhere to mammography guidelines than white women and an even greater gap exists for those above and below the poverty line (Kerans, 2004). Based on evidence from a systematic review of 88 studies, the Community Preventive Services Task Force (CPSTF) recommends multicomponent interventions for breast cancer screening for the greatest impact on underserved

This poster urges the importance of getting examined early so the risk of breast cancer greatly diminishes.

Disparities of all kinds exist in modern day health care. One such disparity that is of particular interest is one that exists between Caucasian and African American women relating to their respective rates of breast cancer incidence and breast cancer survival. According to the American Cancer Society, Caucasian women have a higher incidence of breast cancer than African American women however; Caucasian women have a higher survival rate than African American women (ACS, 2006, as cited in Leshner, 2006). This is to say that although Caucasian woman have a higher rate of breast cancer compared to African American women, Caucasian women have a higher rate of survival. This finding is indeed a disparity in heath care, and one that begs the question as to why this is so. The reasons as to why this disparity exists are numerous and very complex. Several factors play a role in substantiating the disparity in mortality rates related to breast cancer in African American women, including differences in spirituality and religion, differences in education surrounding breast cancer, and differences in socio economic standing as it relates to ones health promotion

Ms. Donnell explained that the Mississippi State Department of Health BCC program offers breast cancer screening services for women age 50-64, and cervical cancer screening to women age 40-64, who meet the program criteria. Ms. Donnell stated that the BCC program comprehensive services include pap test, pelvic exam, clinical breast exam, and mammogram. Further, Ms. Donnell explained that the Medicaid covered period of treatment for breast cancer is two (2) years and the treatment is generally defined as chemotherapy and radiation. Ms. Donnell explained that if Ms. Heigle did provide new medical documentation it would be reviewed for possible an extension of

Every Woman Matters is a federally-funded program that works on early screening for breast and cervical cancer. Despite the barriers number of screening is significant increases in several of the practices. More strategies need to add to make the program for effective and reach under served and uninsured women.

Center for Disease Control and Prevention (CDC's) National Breast and Cervical Cancer Early Detection Program (NBCCEDP) provides access to breast and cervical cancer screening to underserved women in all 50 states. NBCCEDP programs use population-based approaches such as public education, patient navigation, and outreach, care coordination to increase screening and reach underserved and uninsured populations. This program provides cervical screening for 21 to 64 year and breast screening for 40 to 64 years. Since this program initiated in 1991 almost 3.7 million women has been screened and 44,885 cases of breast cancer, 2,554 cervical cancers and123, 563 cervical precursor lesions have been detected (Benard et.al , 2011). NBCCEDP use Conceptual Framework supports a collection of strategies to reach uninsured women, including program controlling, screening and diagnostic services. Team members of the NBCCEDP work collaboratively to provide breast and cervical cancer screening, diagnostic evaluation, treatment and referrals. “The program's continued success depends in large part on the complementary efforts of a variety of national partner organizations, as well as on state and community partners” (CDC, 2012). The key success for these two cancer screening programmes

Nature and scope of the project: Despite the advances in medical technology, breast cancer is the most common cancer among women and is the second cause of mortality in African-American and Caucasian women in the United States. Mammography has shown to be one of the best method to reduce late detection of breast cancer. The American Cancer Society recommends monthly self-breast examination (SBE), clinical breast examination every three years and mammography starting at age of 40. Despite the recommendations, there is a disparity among different racial groups. The breast cancer screening rates are higher in certain subgroups, including low-income African-Americans and Hispanic

In 2010, 14,045 new breast cancer cases were diagnosed among females in Florida and 2,824 females died from it ("Florida Department of Health," n.d.). The incidence and mortality rates were higher among females 65 years of age and older than among females less than 65 years of age. Of all breast cancer cases diagnosed in Florida during 2010, 35.2% were diagnosed at an advanced stage. Florida takes a comprehensive approach in implementing cancer control efforts to reduce disparities, morbidity, and mortality associated with this disease ("Florida Department of Health," n.d.). The Florida Cancer Plan includes 4 goals of addressing the state’s cancer control structure; cancer prevention; diagnosis, treatment and access to cancer care; and cancer

African American’s experience with cancer treatment is different than other ethnicities in the treatments they choose and how the treatments ultimately work. “Although breast-conserving surgery rates have increased among African American women, they still lag behind utilization rates of white women” (Shaver, Brown 339) Although black women choosing mastectomy over breast-conserving may be culturally relative, there are clear quality of life improvements for those who chose breast conserving surgery. (Shaver, Brown 339) If so, then why do African American women choose mastectomy more often? A possible reason can be a lack of knowledge concerning breast cancer and its treatments. Going back to the idea that viewing cancer as a white person’s disease will lead to a lack of interest in learning about cancer. Another aspect to treatment is rejecting treatment all together. It has been shown that “older blacks prefer the use of self-help treatment rather than medical treatments” (Goodwin et al 978) The preference for self-help treatment stems from religious ideologies. Treatment of cancer is directly related to how likely someone will be able survive cancer. Some treatments are proven to be more effective than others yet African American women “had shorter overall survival and disease free survival than white women who received similar adjacent chemotherapy rates.” (Shavers, Brown 338) This difference in prognosis after

In today’s society, women are not getting their mammograms done because they feel they are not necessary or because they are afraid of the results of the mammograms. Since women do not get their mammograms done, they are exposed to breast cancer. According to the National Cancer Institute, women who get mammograms, reduce about “15% to 20% in mortality from breast cancer” (“National Cancer Institute” 1). If women would increase the rate of getting mammograms, there will be less deaths in women.

Breast cancer is the second leading cause of death in women in the United States. A mammogram, is a simple test done with x-ray, to screen women for abnormalities of the breast. Over the past six years, the guidelines put out by various healthcare organizations have changed multiple times on when women should begin screening mammograms. Based on statistical data collected by the Kaiser Family Foundation (KFF), 20 percent of women go without a screening mammogram for their own various reasons, of which may be lack of insurance, lack of time or lack of knowledge as to when they should be getting a screening mammogram done due to the recent changes in recommendations. The utilization of annual screening mammograms beginning at age 40 will continue to help reduce the incidence rate of women with breast cancer, or catch it early enough so that treatment can be sought.

According to Dr. Freemen, the various disparities of breast cancer survival as it relates to the different aspects of SES are that the health care system does not treat Black and White women the same. The disparities regarding treatment of Black and White women is mainly due to socio-economic status and lack of health insurance. In addition, Black women who reside in poverty stricken areas are less likely to receive quality health care. Treatment providers in poverty stricken neighborhoods have large patient ratios while White women receive treatment from providers with small patient ratios. Moreover, poor quality health care and large patient ratios also equate to longer wait times while meeting with providers.

Even though the concept of patient navigation has been around since the 1980’s when Dr. Harold Freeman created a program to help African American women to gain access to screening and cancer treatment, it has evolved over the years and is still

fifty one percent of women under age of fifty who has breast cancer will be identified by

Despite the difficulty, researchers have reported the benefits of screening. The most recognized benefit of health screening according to Durojaiye, (2009) is it’s effectiveness in reducing morbidity and mortality from disease by detecting it before symptoms occur. A report in 2006, by the Advisory Committee on Breast Cancer Screening, shows that screening saves 1,400 lives a year in England. In Australia, The age-standardized breast cancer mortality rate in women of all ages declined significantly from 28 per 100,000 women in 1996 to 24 per 100,000 in 2005. Mortality from breast cancer among women aged 50-69 was reported to have declined from 62 deaths per 100,000 in 1996 to 52 deaths per 100,000 in 2005 (Australian Institute of Health and Welfare, 2008) . Evidence also suggests that a reduction in death rates of around 95% is possible in the long-term with cervical cancer screening. The screening of pregnant women to identify and intervene early with risks to their health and that of their babies are associated with improved health status among high-risk populations (Durojaiye, 2009). The idea of screening therefore is to prevent, not to cure. Pope (1992), stats that screening is the second best option, but one which