Breast Cancer Screening: Improving African American Women Access to Mammography Screening

Breast cancer (BrCa) is the most common cancer diagnosed in American women and the second leading cause of cancer-related death, making it a top public health priority. According to Yedjou et al. (2019), BrCa incidence is quite close between Black women (125.1/100,000) and White women (127.7/per 100,000) in the US, but Black women are 42% more likely to die from this disease, indicating a critical need to increase early detection among this population. The FAU-Northwest Community Health Center Alliance's Community Health Center (CHC) is a Federally Qualified Health Center (FQHC) Look A Like that provides care to thousands of community members with financial disadvantages as well as other barriers, which limits access to care. This DNP project examined barriers to mammography completion among Black/AA women who received care at the CHC through a medical record review and survey. The medical record of Black women between ages 40-74 who were eligible to receive a mammogram revealed that only (57%) completed a mammogram within the past 4 years and even fewer completed a mammogram within the past 2 years (35%). After surveying a sample of these women (n=25), we found higher self-reported rates of mammography screening (80%) within the past 4 years and (68%) within the past 2 years. Participants reported perceived barriers and perceived benefits of mammography screening. Findings of this QI project showed multilevel influential factors work in combination to impact mammography compliance. For example, combined sociodemographic factors (age, education, family medical history, language, and insurance status) had significant impact on mammography completion (p=0.035). Additionally, an open-ended survey item, revealed these barriers: no insurance, age criteria for mammogram not met, Covid-19, lack of financial stability, fear of pain and exposure to mammography, and no current pain. Recommendations include strategies for improving Black/AA women access to mammography screening.