Community-based cancer screening for underserved women: Design and baseline findings from the Breast and Cervical Cancer Intervention Study

R. A. Hiatt, R. J. Pasick, Susan L Stewart, J. Bloom, P. Davis, P. Gardiner, M. Johnston, J. Luce, K. Schorr, W. Brunner, F. Stroud

Research output: Contribution to journalArticle

155 Citations (Scopus)

Abstract

Background. Underutilization of breast and cervical cancer screening has been observed in many ethnic groups and underserved populations. Effective community-based interventions are needed to eliminate disparities in screening rates and thus to improve prospects for survival. Methods. The Breast and Cervical Cancer Intervention Study was a controlled trial of three interventions in the San Francisco Bay Area from 1993 to 1996: (1) community-based lay health worker outreach; (2) clinic-based provider training and reminder system; and (3) patient navigator for follow-up of abnormal screening results. Study design and a description of the interventions are reported along with baseline results of a household survey conducted in four languages among 1599 women, aged 40-75. Results. Seventy-six percent of women ages 40 and over had had at least one mammogram, and most had had a clinical breast examination (88%) and Pap smear (89%). Rates were significantly lower for non-English. speaking Latinas and Chinese women (56 and 32%, respectively, for mammography), and maintenance screening (three mammograms in the past 5 years) varied from 7% (non-English-speaking Chinese) to 53% (Blacks). Pap smear screening in the past 3 years was low among non-English-speaking Latinas (72%) and markedly lower among non-English-speaking Chinese women (24%). The strongest predictors of screening behavior were having private health insurance and frequent use of medical services. Having a regular clinic and speaking English were also important. Race/ethnicity, education, household income, and employment status were, overall, not significant predictors of screening behavior. Conclusions. These baseline results support the importance of cancer screening interventions targeted to persons of foreign origin, particularly those less acculturated.

Original languageEnglish (US)
Pages (from-to)190-203
Number of pages14
JournalPreventive Medicine
Volume33
Issue number3
DOIs
StatePublished - 2001
Externally publishedYes

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Early Detection of Cancer
Uterine Cervical Neoplasms
Breast Neoplasms
Papanicolaou Test
Hispanic Americans
Patient Navigation
Reminder Systems
San Francisco
Vulnerable Populations
Mammography
Health Insurance
Ethnic Groups
Breast
Language
Maintenance
Education
Survival
Health

Keywords

  • Behavior
  • Breast neoplasms
  • Cancer
  • Cervix neoplasms
  • Health surveys
  • Intervention studies
  • Low-income
  • Mass screening
  • Minority

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Community-based cancer screening for underserved women : Design and baseline findings from the Breast and Cervical Cancer Intervention Study. / Hiatt, R. A.; Pasick, R. J.; Stewart, Susan L; Bloom, J.; Davis, P.; Gardiner, P.; Johnston, M.; Luce, J.; Schorr, K.; Brunner, W.; Stroud, F.

In: Preventive Medicine, Vol. 33, No. 3, 2001, p. 190-203.

Research output: Contribution to journalArticle

Hiatt, RA, Pasick, RJ, Stewart, SL, Bloom, J, Davis, P, Gardiner, P, Johnston, M, Luce, J, Schorr, K, Brunner, W & Stroud, F 2001, 'Community-based cancer screening for underserved women: Design and baseline findings from the Breast and Cervical Cancer Intervention Study', Preventive Medicine, vol. 33, no. 3, pp. 190-203. https://doi.org/10.1006/pmed.2001.0871
Hiatt, R. A. ; Pasick, R. J. ; Stewart, Susan L ; Bloom, J. ; Davis, P. ; Gardiner, P. ; Johnston, M. ; Luce, J. ; Schorr, K. ; Brunner, W. ; Stroud, F. / Community-based cancer screening for underserved women : Design and baseline findings from the Breast and Cervical Cancer Intervention Study. In: Preventive Medicine. 2001 ; Vol. 33, No. 3. pp. 190-203.
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title = "Community-based cancer screening for underserved women: Design and baseline findings from the Breast and Cervical Cancer Intervention Study",
abstract = "Background. Underutilization of breast and cervical cancer screening has been observed in many ethnic groups and underserved populations. Effective community-based interventions are needed to eliminate disparities in screening rates and thus to improve prospects for survival. Methods. The Breast and Cervical Cancer Intervention Study was a controlled trial of three interventions in the San Francisco Bay Area from 1993 to 1996: (1) community-based lay health worker outreach; (2) clinic-based provider training and reminder system; and (3) patient navigator for follow-up of abnormal screening results. Study design and a description of the interventions are reported along with baseline results of a household survey conducted in four languages among 1599 women, aged 40-75. Results. Seventy-six percent of women ages 40 and over had had at least one mammogram, and most had had a clinical breast examination (88{\%}) and Pap smear (89{\%}). Rates were significantly lower for non-English. speaking Latinas and Chinese women (56 and 32{\%}, respectively, for mammography), and maintenance screening (three mammograms in the past 5 years) varied from 7{\%} (non-English-speaking Chinese) to 53{\%} (Blacks). Pap smear screening in the past 3 years was low among non-English-speaking Latinas (72{\%}) and markedly lower among non-English-speaking Chinese women (24{\%}). The strongest predictors of screening behavior were having private health insurance and frequent use of medical services. Having a regular clinic and speaking English were also important. Race/ethnicity, education, household income, and employment status were, overall, not significant predictors of screening behavior. Conclusions. These baseline results support the importance of cancer screening interventions targeted to persons of foreign origin, particularly those less acculturated.",
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T1 - Community-based cancer screening for underserved women

T2 - Design and baseline findings from the Breast and Cervical Cancer Intervention Study

AU - Hiatt, R. A.

AU - Pasick, R. J.

AU - Stewart, Susan L

AU - Bloom, J.

AU - Davis, P.

AU - Gardiner, P.

AU - Johnston, M.

AU - Luce, J.

AU - Schorr, K.

AU - Brunner, W.

AU - Stroud, F.

PY - 2001

Y1 - 2001

N2 - Background. Underutilization of breast and cervical cancer screening has been observed in many ethnic groups and underserved populations. Effective community-based interventions are needed to eliminate disparities in screening rates and thus to improve prospects for survival. Methods. The Breast and Cervical Cancer Intervention Study was a controlled trial of three interventions in the San Francisco Bay Area from 1993 to 1996: (1) community-based lay health worker outreach; (2) clinic-based provider training and reminder system; and (3) patient navigator for follow-up of abnormal screening results. Study design and a description of the interventions are reported along with baseline results of a household survey conducted in four languages among 1599 women, aged 40-75. Results. Seventy-six percent of women ages 40 and over had had at least one mammogram, and most had had a clinical breast examination (88%) and Pap smear (89%). Rates were significantly lower for non-English. speaking Latinas and Chinese women (56 and 32%, respectively, for mammography), and maintenance screening (three mammograms in the past 5 years) varied from 7% (non-English-speaking Chinese) to 53% (Blacks). Pap smear screening in the past 3 years was low among non-English-speaking Latinas (72%) and markedly lower among non-English-speaking Chinese women (24%). The strongest predictors of screening behavior were having private health insurance and frequent use of medical services. Having a regular clinic and speaking English were also important. Race/ethnicity, education, household income, and employment status were, overall, not significant predictors of screening behavior. Conclusions. These baseline results support the importance of cancer screening interventions targeted to persons of foreign origin, particularly those less acculturated.

AB - Background. Underutilization of breast and cervical cancer screening has been observed in many ethnic groups and underserved populations. Effective community-based interventions are needed to eliminate disparities in screening rates and thus to improve prospects for survival. Methods. The Breast and Cervical Cancer Intervention Study was a controlled trial of three interventions in the San Francisco Bay Area from 1993 to 1996: (1) community-based lay health worker outreach; (2) clinic-based provider training and reminder system; and (3) patient navigator for follow-up of abnormal screening results. Study design and a description of the interventions are reported along with baseline results of a household survey conducted in four languages among 1599 women, aged 40-75. Results. Seventy-six percent of women ages 40 and over had had at least one mammogram, and most had had a clinical breast examination (88%) and Pap smear (89%). Rates were significantly lower for non-English. speaking Latinas and Chinese women (56 and 32%, respectively, for mammography), and maintenance screening (three mammograms in the past 5 years) varied from 7% (non-English-speaking Chinese) to 53% (Blacks). Pap smear screening in the past 3 years was low among non-English-speaking Latinas (72%) and markedly lower among non-English-speaking Chinese women (24%). The strongest predictors of screening behavior were having private health insurance and frequent use of medical services. Having a regular clinic and speaking English were also important. Race/ethnicity, education, household income, and employment status were, overall, not significant predictors of screening behavior. Conclusions. These baseline results support the importance of cancer screening interventions targeted to persons of foreign origin, particularly those less acculturated.

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KW - Breast neoplasms

KW - Cancer

KW - Cervix neoplasms

KW - Health surveys

KW - Intervention studies

KW - Low-income

KW - Mass screening

KW - Minority

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