Lasting effects of the breast and cervical cancer early detection program on breast cancer detection and outcomes, Ohio, 2000-2009

Siran M. Koroukian, Paul M. Bakaki, Xiaozhen Han, Mark Schluchter, Cynthia Owusu, Gregory S. Cooper, Sue Flocke

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

Introduction: The National Breast and Cervical Cancer Early Detection Program (BCCP) in Ohio provides screening and treatment services for uninsured low-income women aged 40 to 64. Because participation in the BCCP might engender greater self-efficacy for cancer screening, we hypothesized that breast cancer and survival outcomes would be better in BCCP participants who become age-eligible to transition to Medicare than in their low-income non- BCCP counterparts. Methods: Linking data from the 2000 through 2009 Ohio Cancer Incidence Surveillance System with the BCCP database, Medicare files, Ohio death certificates (through 2010), and the US Census, we identified Medicare beneficiaries who were aged 66 to 74 and diagnosed with incident invasive breast cancer. We compared the following outcomes between BCCP women (n = 93) and low-income non-BCCP women (n = 420): receipt of screening mammography in previous year, advanced-stage disease at diagnosis, timely and standard care, all-cause survival, and cancer survival. We conducted multivariable logistic regression and survival analysis to examine the association between BCCP status and each of the outcomes, adjusting for patient covariates. Results: Women who participated in the BCCP were nearly twice as likely as low-income non-BCCP women to have undergone screening mammography in the previous year (adjusted odds ratio, 1.77; 95% confidence interval, 1.01-3.09). No significant differences were detected in any other outcomes. Conclusion: With the exception of screening mammography, the differences in outcomes were not significant, possibly because of the small size of the study population. Future analysis should be directed toward identifying the factors that explain these findings.

Original languageEnglish (US)
Article number140491
JournalPreventing Chronic Disease
Volume12
Issue number7
DOIs
StatePublished - Jan 1 2015
Externally publishedYes

Fingerprint

Uterine Cervical Neoplasms
Breast Neoplasms
Mammography
Medicare
Survival
Death Certificates
Censuses
Self Efficacy
Survival Analysis
Population Density
Early Detection of Cancer
Neoplasms
Logistic Models
Odds Ratio
Regression Analysis
Databases
Confidence Intervals
Incidence

ASJC Scopus subject areas

  • Health Policy
  • Public Health, Environmental and Occupational Health

Cite this

Lasting effects of the breast and cervical cancer early detection program on breast cancer detection and outcomes, Ohio, 2000-2009. / Koroukian, Siran M.; Bakaki, Paul M.; Han, Xiaozhen; Schluchter, Mark; Owusu, Cynthia; Cooper, Gregory S.; Flocke, Sue.

In: Preventing Chronic Disease, Vol. 12, No. 7, 140491, 01.01.2015.

Research output: Contribution to journalArticle

Koroukian, Siran M. ; Bakaki, Paul M. ; Han, Xiaozhen ; Schluchter, Mark ; Owusu, Cynthia ; Cooper, Gregory S. ; Flocke, Sue. / Lasting effects of the breast and cervical cancer early detection program on breast cancer detection and outcomes, Ohio, 2000-2009. In: Preventing Chronic Disease. 2015 ; Vol. 12, No. 7.
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abstract = "Introduction: The National Breast and Cervical Cancer Early Detection Program (BCCP) in Ohio provides screening and treatment services for uninsured low-income women aged 40 to 64. Because participation in the BCCP might engender greater self-efficacy for cancer screening, we hypothesized that breast cancer and survival outcomes would be better in BCCP participants who become age-eligible to transition to Medicare than in their low-income non- BCCP counterparts. Methods: Linking data from the 2000 through 2009 Ohio Cancer Incidence Surveillance System with the BCCP database, Medicare files, Ohio death certificates (through 2010), and the US Census, we identified Medicare beneficiaries who were aged 66 to 74 and diagnosed with incident invasive breast cancer. We compared the following outcomes between BCCP women (n = 93) and low-income non-BCCP women (n = 420): receipt of screening mammography in previous year, advanced-stage disease at diagnosis, timely and standard care, all-cause survival, and cancer survival. We conducted multivariable logistic regression and survival analysis to examine the association between BCCP status and each of the outcomes, adjusting for patient covariates. Results: Women who participated in the BCCP were nearly twice as likely as low-income non-BCCP women to have undergone screening mammography in the previous year (adjusted odds ratio, 1.77; 95{\%} confidence interval, 1.01-3.09). No significant differences were detected in any other outcomes. Conclusion: With the exception of screening mammography, the differences in outcomes were not significant, possibly because of the small size of the study population. Future analysis should be directed toward identifying the factors that explain these findings.",
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