Published in Cancer Detection and Prevention 2001; 25(2):138-146.

Early Indicators of the Effect of a Breast Cancer Screening Program for Low-Income Women

Mario Schootman, PhDa and Laurence J. Fuortes, MDb

aDivision of Health Behavior Research, Departments of Internal Medicine and Pediatrics, Washington University School of Medicine, St. Louis, MO, and bDepartment of Epidemiology, College of Public Health, University of Iowa, Iowa City, IA

Address all correspondence and reprint requests to: Mario Schootman, PhD, Division of Health Behavior Research, Departments of Internal Medicine and Pediatrics, The Alvin I. Siteman Cancer Center at Barnes-Jewish Hospital and Washington University School of Medicine, 4444 Forest Park Parkway, Box 8504, St. Louis, MO 63108.

ABSTRACT: The National Breast and Cervical Cancer Early Detection Program (NBCCEDP) was developed to increase screening among low-income women who are uninsured or underinsured. This study reports early indicators of the effectiveness of this breast-screening program in Iowa. Using data from the Census Bureau and the Iowa Behavioral Risk Factor Surveillance System, we found that racial and ethnic minorities aged 50 to 64 more likely were screened by the NBCCEDP than were their counterparts. Data collected by the Iowa BCCEDP showed a breast cancer detection rate (7.1 per 1,000 women screened) that was at least three times higher than its historical comparison, an indication of the lead time of the screened over the nonscreened population. Predictive values positive (referral and biopsy) and stage distribution were typically higher than for the national program but lower than in other countries. In conclusion, a breast cancer screening program among low-income women can be implemented successfully, judged by early indicators of program effectiveness.

KEY WORDS: breast neoplasms, early detection, evaluation.