Urgent care settings may offer breast cancer screening opportunity

2016 12 06 12 25 03 674 Breast Screening Mammo 400

Nearly one in three women who did not obtain recommended breast cancer screening in a year have visited urgent care centers, according to an April 20 presentation delivered at the American Roengten Ray Society (ARRS) annual meeting.

The study suggests that urgent care and other care settings could offer opportunities for mammography screening, presenter Dr. Anand Narayan, PhD, from the University of Wisconsin noted. At the meeting, he shared results from research that included data from more than 9,000 women and found that, among women who did not undergo mammography screening within the past year, about 23% reported visiting an emergency room and nearly 10% reported being hospitalized -- suggesting untapped potential in these settings for preventive breast health services.

"Among the different sites, we have several opportunities to increase access for mammography screening," Narayan said.

To improve adherence to recommended mammography screening, clinics often collaborate with primary care providers. However, Narayan said lack of access to primary care providers is a key risk factor for not being up to date with recommended breast cancer screening. He and his team sought to estimate the proportion of women visiting urgent care centers, emergency departments, or being hospitalized who were not current with recommended mammography screening. The study goal was to explore the potential impact of nonprimary care-based cancer screening interventions.

The investigators used data from the 2019 National Health Interview Survey that included information from 9,139 women between the ages of 40 and 74 with no prior history of breast cancer.

The team found the following:

  • 44.9% did not report receiving a mammogram within the last year.
  • 29.2% reported visiting an urgent care center.
  • 21.8% of women who did not report receiving a mammogram did report visiting an emergency room.
  • 9.6% reported being hospitalized.

Women of "other" race and white women were most likely to visit an urgent care center, at 33.9% and 30.2%, respectively. Further data analysis also found that Black women were more likely than white women to report undergoing mammography screening, with an odds ratio (OR) of 1.81 (p = 0.021) and that uninsured women visiting urgent care centers were less likely to report breast cancer screening, with an OR of 0.34 (p < 0.001).

However, women of "other" race and Black women had the highest percentages of reporting use of emergency departments at 38.1% and 32.3%, respectively. While college-educated women in this setting were more likely to report undergoing mammography screening (OR, 1.51; p = 0.047), uninsured women again were less likely to report undergoing screening (OR, 0.43; p = 0.015).

Native American women and Black women had the highest percentages of those hospitalized, at 13% each. However, like in the emergency department, hospitalized, college-educated women were more likely to report undergoing screening mammography while uninsured women were less likely.

"Non-primary care-based visits may represent important opportunities to improve breast screening rates through patient education and targeted interventions," Narayan said.

More specifically, urgent care centers can reach out to a large number of women in a less acute setting, and emergency departments meanwhile can increase screening outreach.

Narayan added that his team is working through such opportunities and strategies as offering educational materials at urgent care centers.

"A lot of this [possible screening opportunity] depends on the bandwidth of different types of clinician groups to engage in these initiatives," he said.

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