Factors that Influence Mammography Use for Breast Cancer Screening among African American Women

Orji, Chinelo C.; Kanu, Chisom; Adelodun, Anuoluwapo I.; Brown, Carolyn M.

doi:10.1016/j.jnma.2020.05.004

Cited by 19 publications

(28 citation statements)

References 27 publications

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“…Our study highlights the influence of a critical social determinant of health, healthcare access, and lung cancer screening uptake among eligible patients. These results are consistent with prior research suggesting the relative importance of access on engagement with a range of cancer screening behaviors ( 34 – 36 ). Therefore, additional efforts to identify which health care coverage serves as a barrier to obtaining lung cancer screening among eligible patients are needed.…”

Section: Discussionsupporting

confidence: 91%

“…For example, Andersen's behavioral model of health services utilization has defined access to care (e.g., health insurance, proximity to healthcare facility) as one of the enabling factors related to health services utilization, including cancer screening ( 33 ). Prior research has shown poor access to health care is associated with disparities in breast, cervical, and colorectal cancer screening across various patient populations ( 34 – 36 ). However, limited research exists related to the influence of access to care on lung cancer screening after controlling for patient demographic characteristics (e.g., age, race, sex) and smoking behaviors (current smoking status and frequency and length of time smoked).…”

Section: Introductionmentioning

confidence: 99%

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Examination of the Association Between Access to Care and Lung Cancer Screening Among High-Risk Smokers

Matthews

Kao

et al. 2021

Front. Public Health

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Objective: The purpose of this study was to examine the influence of access to care on the uptake of low-dose computed tomography (LDCT) lung cancer screening among a diverse sample of screening-eligible patients.Methods: We utilized a cross-sectional study design. Our sample included patients evaluated for lung cancer screening at a large academic medical center (AMC) between 2015 and 2017 who met 2013 USPSTF guidelines for LDCT screening eligibility. The completion of LDCT screening (yes, no) was the primary dependent variable. The independent variable was access to care (insurance type, living within the AMC service area). We utilized binary logistic regression analyses to examine the influence of access to care on screening completion after adjusting for demographic factors (age, sex, race) and smoking history (current smoking status, smoking pack-year history).Results: A total of 1,355 individuals met LDCT eligibility criteria, and of those, 29.8% (n = 404) completed screening. Regression analysis results showed individuals with Medicaid insurance (OR, 1.51; 95% CI, 1.03-2.22), individuals living within the AMC service area (OR, 1.71; 95% CI, 1.21–2.40), and those aged 65–74 years (OR, 1.49; 95% CI, 1.12–1.98) had higher odds of receiving LDCT lung cancer screening. Lower odds of screening were associated with having Medicare insurance (OR, 0.30; 95% CI, 0.22–0.41) and out-of-pocket (OR, 0.27; 95% CI, 0.15–0.47).Conclusion: Access to care was independently associated with lowered screening rates. Study results are consistent with prior research identifying the importance of access factors on uptake of cancer early detection screening behaviors.

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Section: Discussionsupporting

confidence: 91%

Section: Introductionmentioning

confidence: 99%

Examination of the Association Between Access to Care and Lung Cancer Screening Among High-Risk Smokers

Matthews

Kao

et al. 2021

Front. Public Health

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“…For example, enabling factors may have the largest influence on screening for African American women, who are more likely to encounter various societal and systemic barriers that lead to increased risk for being uninsured and low-income relative to White women [16][17][18]. Even if breast cancer screenings are available free of charge, low-income individuals may face barriers to receiving them (e.g., no childcare to allow a health provider visit, difficulty with obtaining transportation) [19]. On the other hand, need factors may drive breast cancer screening adherence given the burden of breast cancer mortality experienced by this group, or they may moderate the association between enabling and/or predisposing factors and screening adherence.…”

Section: Introductionmentioning

confidence: 99%

“…One notable recent study that used the Andersen model to examine factors associated with breast cancer screening among Indigenous women found that, among predisposing factors, age was a significant predictor of breast cancer screening [14]. Among enabling factors, women with more formal education were more likely to undergo breast cancer screening [19]. Among need factors, participants with family cancer history were more likely to undergo breast cancer screening [19].…”

Section: Introductionmentioning

confidence: 99%

“…Among enabling factors, women with more formal education were more likely to undergo breast cancer screening [19]. Among need factors, participants with family cancer history were more likely to undergo breast cancer screening [19]. The extent to which this would generalize to African American women is not known; however, similar to Indigenous women, some African American women have lower median wages and employment rates than White women.…”

Section: Introductionmentioning

confidence: 99%

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Factors Associated with Breast Cancer Screening Adherence among Church-Going African American Women

Agrawal

Chen

McNeill

et al. 2021

IJERPH

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Relative to White women, African American/Black women are at an increased risk of breast cancer mortality. Early detection of breast cancer through mammography screening can mitigate mortality risks; however, screening rates are not ideal. Consequently, there is a need to better understand factors associated with adherence to breast cancer screening guidelines to inform interventions to increase mammography use, particularly for groups at elevated mortality risk. This study used the Andersen Behavioral Model of Health Services Use to examine factors associated with adherence to National Comprehensive Cancer Network breast cancer screening guidelines amongst 919 African American, church-going women from Houston, Texas. Logistic regression analyses measured associations between breast cancer screening adherence over the preceding 12 months (adherent or non-adherent) and predisposing (i.e., age, education, and partner status), enabling (i.e., health insurance status, annual household income, employment status, patient-provider communication, and social support), and need (i.e., personal diagnosis of cancer, family history of cancer, and risk perception) factors, separately and conjointly. Older age (predisposing: OR = 1.015 (1.007–1.023)), having health insurance and ideal patient–provider communication (enabling: OR = 2.388 (1.597–3.570) and OR = 1.485 (1.080–2.041)), and having a personal diagnosis of cancer (need: OR = 2.244 (1.058–4.758)) were each associated with greater odds of screening adherence. Only having health insurance and ideal patient-provider communication remained significantly associated with screening adherence in a conjoint model; cancer survivorship did not moderate associations between predisposing/enabling factors and screening adherence. Overall, results suggest that interventions which are designed to improve mammography screening rates amongst African American women might focus on broadening health insurance coverage and working to improve patient–provider communication. Implications for multi-level intervention approaches, including the role of churches in their dissemination, are proposed.

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In pursuit of equity in cancer care: Moving beyond the Affordable Care Act

Dee

Pierce

Winkfield

et al. 2022

Cancer

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Although Medicaid Expansion under the Patient Protection and Affordable Care Act (ACA) has been associated with many improvements for patients with cancer, Snyder et al. provide evidence demonstrating the persistence of racial disparities in cancer.• This Editorial describes why insurance coverage alone does not ensure access to health care, highlights various manifestations of structural racism that constitute barriers to access beyond the direct costs of care, and calls for not just equality, but equity, in cancer care.

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Factors that Influence Mammography Use for Breast Cancer Screening among African American Women

Cited by 19 publications

References 27 publications

Examination of the Association Between Access to Care and Lung Cancer Screening Among High-Risk Smokers

Examination of the Association Between Access to Care and Lung Cancer Screening Among High-Risk Smokers

Factors Associated with Breast Cancer Screening Adherence among Church-Going African American Women

In pursuit of equity in cancer care: Moving beyond the Affordable Care Act

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