Breast Cancer Screening Trends among Lower Income Women of New York: A Time-Series Evaluation of a Population-Based Intervention

Abstract

Objective:This study aimed to compare the screening rate trends of mammography among New York State’s lower-income women and the higher-income women from 1988 to 2010, and evaluate the potential influence of New York State’s Breast Cancer Early Detection Program (introduced in 1994) on the mammography use rates of lower-income women.Materials and Methods:Lower-income women are defined as women aged 40 and over whose household income is lower than 250% of the single member household federal poverty level (FPL) in the year that they participated in the survey. Higher-income women are defined as women aged 40 and over whose income is greater than 250% of the five-person household FPL. Data were obtained from the Behavioral Risk Factor Sur-veillance System. Interrupted time series analysis was conducted to examine screening rates before and after the launch of the Breast Cancer Early Detection program.Results:Among the lower-income women, the pre-intervention mammography screening rate significantly increased by an average of 15.21% every two years. However, after implementation of the Breast Cancer Early Detection Program, this rate of increase significantly slowed (slope change=-13.67, p=0.00016). The lower-income women and the higher-income women experienced a similar trend change after the intervention started.Conclusion:This study found limited evidence that the Breast Cancer Early Detection Programme significantly contributed to the state-wide increase in mammography screening rate among lower-income women from 1988 to 2010. Future studies should examine the influence of structural and individual barriers inhibiting uptake of mammography screening among lower-income women.

Keywords

• health disparities
• socioeconomic
• segmented regression
• united states