Exploratory Study of Breast Cancer Screening Practices of Urban Women: A Closer Look at Who Is and Is Not Getting Screened.

Several initiatives have been embarked upon over the past decade to encourage breast cancer screening and follow-up among women who reside in urban communities. With these efforts, data revealed that many women do not receive the recommended breast cancer screening. Studies have been published in scientific literature that explored barriers faced by women relative to breast cancer screening. But, only a few reports have been published of efforts initiated to define the limits of characteristics of women who have and women who have not been screened. This cross-sectional exploratory study was designed to examine the breast cancer screening practices of women 40-74 years of age and older who reside in a densely populated metropolitan community of S.E. Wisconsin, and to identify and compare the characteristics of women who report breast cancer screening and with characteristics of women who report no breast cancer screening. The organizing framework for this study was derived from the United States Department of Health and Human Services Determinants of Health Model. An investigator-designed instrument was used to assess the influence of age, family history of breast cancer insurance status, characteristics of residential neighborhood and local access to breast care on breast cancer screening. While the majority of the women surveyed reported breast cancer screening, less than half of the women reported screening that was consistent with recommended breast cancer screening guidelines (i.e. annual mammography and annual clinical breast examination). Deficits in breast cancer screening were noted most among women who were uninsured, with no knownfamily history of breast cancer, who resided in low income neighborhoods, inner-city neighborhoods and neighborhoods without facilities for primary breast care. The results of this study demonstrate the needfor clinicians, health care administrators and advocates committed to breast cancer detection and control within targeted communities. They must carefully assess the impact of individual, social and structural factors on breast cancer screening, and the need to design initiatives specifically targeted to women who have received less than optimal or no breast cancer screening.