Increasing breast and cervical cancer screening in low-income women

J Gen Intern Med. 1998 Aug;13(8):515-21. doi: 10.1046/j.1525-1497.1998.00161.x.

Abstract

Objective: To determine if women would have higher breast and cervical cancer screening rates if lay health advisers recommended screening and offered a convenient screening opportunity.

Design: Controlled trial.

Setting: Urban county teaching hospital.

Participants: Women aged 40 years and over attending appointments in several non-primary-care outpatient clinics.

Interventions: Lay health advisers assessed the participants' breast and cervical cancer screening status and offered women in the intervention group who were due for screening an appointment with a female nurse practitioner.

Measurements and main results: Screening rates at baseline and at follow-up 1 year after the intervention were determined. At follow-up, the mammography rate was 69% in the intervention group versus 63% in the usual care group (p = .009), and the Pap smear rate was 70% in the intervention group versus 63% in the usual care group (p = .02). In women who were due for screening at baseline, the mammography rate was 60% in the intervention group versus 50% in the usual care group (p = .006), and the Pap smear rate was 63% in the intervention group versus 50% in the usual care group (p = .002). The intervention was effective across age and insurance payer strata, and was particularly effective in Native American women.

Conclusions: Breast and cervical cancer screening rates were improved in women attending non-primary-care outpatient clinics by using lay health advisers and a nurse practitioner to perform screening. The effect was strongest in women in greatest need of screening.

Publication types

  • Clinical Trial
  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Adult
  • Aged
  • Breast Neoplasms / diagnosis*
  • Chi-Square Distribution
  • Community Health Nursing
  • Community Health Workers
  • Ethnic Groups
  • Female
  • Health Services Accessibility
  • Hospitals, Teaching
  • Humans
  • Logistic Models
  • Mammography / statistics & numerical data
  • Mass Screening / nursing*
  • Mass Screening / statistics & numerical data
  • Middle Aged
  • Odds Ratio
  • Papanicolaou Test
  • Patient Compliance
  • Poverty*
  • Surveys and Questionnaires
  • Urban Population
  • Uterine Cervical Neoplasms / diagnosis*
  • Vaginal Smears / statistics & numerical data