Latina and Black/African American Women’s Perspectives on Cancer Screening and Cancer Screening Reminders

Abstract

Introduction Racial and ethnic disparities continue to exist in cancer screening rates, especially among U.S. Latina and Black/African American populations. We conducted six focus groups among 41 women from these communities in order to better understand their preferences about cancer screening reminders and the motivators and deterrents they face in obtaining recommended breast, cervical and colon cancer screening. Methods Using self-reported patient race/ethnicity from electronic medical records of a large, integrated health care system in Seattle, we recruited women ages 30–60 to participate in one of five two-hour focus groups. Using verbatim transcripts from these discussions, we conducted a qualitative analysis to identify common themes. Results The focus group participants were primarily strong endorsers and utilizers of recommended breast, cervical and colon cancer screening services. Insurance and belief in preventive care were the most common motivators that they cited in obtaining cancer screening. However, they still reported multiple barriers to getting recommended cancer screening for themselves and community members, including lack of time, conflicting information about screening intervals, distrust in the health care system, and a lack of understanding of the benefits of preventive care. Conclusions Efforts to improve understanding about the benefits of cancer screening, clarify cancer screening guideline recommendations, increase cultural competency among health care professionals, and expand the times and locations where cancer screening is available are all options that may improve cancer screening rates among Latinas and Black/African American women.

Are We Choosing Wisely? Older Adults’ Cancer Screening Intentions and Recalled Discussions with Physicians About Stopping

“…Results are consistent with prior qualitative work showing black individuals have positive attitudes towards cancer screening. [40][41][42] Future work is needed to confirm this finding and determine if considerations of race/ethnicity should be incorporated into efforts to reduce overscreening.…”

Breast cancer screening outreach effectiveness: Mammogram-specific reminders vs. comprehensive preventive services birthday letters

“…However, we were able to conduct 11 focus groups with 66 women (21–75 years) to understand motivators and barriers to obtaining cancer screening and preferences about reminders following the birthday letter roll out; no single optimal strategy was identified. 52,53 Differences by age and health beliefs drove participants’ screening choices and reminder preferences. The importance of personalized, proactive outreach may have been inadvertently reduced with the birthday letter, but could be substantially increased with a better understanding of what works for mammography outreach for different women.…”

“…54 Successful reminders require a health care system to be nimble enough to use a multi-faceted approach that allows customization. 52,53 …”

The Breast and Cervical Cancer Early Detection Program, Medicaid, and breast cancer outcomes among Ohio's underserved women

“…In addition, racial disparities in breast cancer screening, stage, tumor biology, treatment, and survival outcomes have been well documented. Health insurance is a key motivator not only for seeking cancer‐screening services and receiving cancer care, especially among women of ethnic/racial minority backgrounds, but also for obtaining timely diagnostic follow‐up after a positive screening mammogram …”

“…2,3 In addition, racial disparities in breast cancer screening, 4,5 stage, 6,7 tumor biology, 8,9 treatment, 7,10-12 and survival outcomes 7,9,13,14 have been well documented. Health insurance is a key motivator not only for seeking cancer-screening services 15 and receiving cancer care, 3 especially among women of ethnic/racial minority backgrounds, [16][17][18] but also for obtaining timely diagnostic follow-up after a positive screening mammogram. 19 The Breast and Cervical Cancer Early Detection Program (BCCEDP), initiated by the Centers for Disease Control and Prevention, is an organized screening program that has played a central role in improving breast cancer outcomes among underserved women since the early 1990s.…”