Patient Reported Barriers to Utilization of Screening Mammography
Patient Reported Barriers to Utilization of Screening Mammography During the COVID-19 Pandemic Babayemi 1 The 1, 2 O , Malinowski 1, 2 C , Teshome 2 M University of Texas Health Science Center - School of Public Health 2 The University of Texas MD Anderson Cancer Center RESULTS BACKGROUND • Screening for early detection of cervical, breast, and colon cancer dramatically decreased by over 85% in the United States due to the COVID-19 pandemic. 1 ● • The Rose, a safety net clinic in Houston, TX, experienced a sharp decline in screening mammograms from 2019 to 2020 compared to previous years. The goal was to evaluate patient reported COVID-19 -related barriers and understand the pandemic’s impact on The Rose’s patient population access of mammography screening. ● Participant Characteristics (Total N=285) N (%) Age METHODS • Self-reported survey via email to: • Patients who received screening mammogram at The Rose between 6/2019 - 8/2019 but did not return for one between 6/2020 - 12/2020 • Survey questions explored demographic factors and participants’ perceptions about potential COVID-19 related barriers contributing to their lack of screening on a 5 -item Likert scale. Demographics Age Potential Barriers Access to transportation Race Job instability Ethnicity Insurance status Financial status Perceived risk of contracting COVID-19 County Perceived risk of developing breast cancer DATA ANALYSIS • Descriptive statistical methods were used to analyze demographic and socioeconomic barriers to screening behaviors. TRENDS IN DISTRIBUTION 41 (14. 4) 85 (29. 8) 77 (27. 0) 81 (28. 4) 1 (0. 4) Hispanic Non-Hispanic Prefer not to answer 89 (31. 2) 187 (65. 6) 9 (3. 2) American Indian or Alaskan Native Asian Black or African American White Other Prefer not to answer 1 (0. 4) 11 (3. 8) 40 (14. 0) 187 (65. 6) 16 (5. 6) 30 (10. 5) Ethnicity Race Income (Derived from County Aggregate) $20, 000 - $44, 999 $45, 000 - $59, 999 $60, 000 - $74, 999 $75, 000 - $89, 999 >$90, 000 Other Prefer not to answer Free mammogram services Yes No Unsure Prefer not to answer 1 (0. 4) 4 (1. 4) 181 (63. 5) 39 (13. 7) 52 (18. 3) 4 (1. 4) 82 (28. 8) 158 (55. 4) 43 (15. 1) 2 (0. 7) Difference in distribution of patient reliance on public transportation according to history of financial assistance at The Rose (p=0. 0044) CONCLUSIONS ● 35 -44 45 -54 55 -64 65+ Prefer not to answer Significant difference in distribution by ethnicity for the following: ○ Concern for contracting COVID-19 (p=0. 0117) ○ Reliance on public transportation (p=0. 0000) ○ Reliance on public transportation specifically for mammography access (p=0. 0003) ● Within this population of high-risk women, reported barriers to achieving a follow-up screening mammogram in 2020 -21 were loss of job or medical insurance, restricted availability of public transportation, and concern for contracting COVID-19. These barriers were differentially expressed by demographic factors such as ethnicity and receipt of financial assistance. FUTURE CONSIDERATIONS Expand survey to include: 1. Non-traditional barriers to engagement with medical system (i. e. social factors) 1. Impact of COVID-19 related barriers on breast cancer incidence, advancestage diagnosis, and oncologic outcomes ACKNOWLEDGEMENTS Patient data was obtained from The Rose Clinic in Houston, TX. Special thanks at The Rose to Dorothy Gibbons, Co-Founder & Chief Executive Officer, and Bernice Joseph, Chief Operating Officer. 1 AACR FUNDING: This work was supported by The Rose and Susan G. Komen Cancer Disparities Progress Report 2020 | Cancer Progress Report [Internet]. [cited 2020 Sep 19]. Available from: https: //cancerprogressreport. aacr. org/disparities/
- Slides: 1