The 131st Annual Meeting (November 15-19, 2003) of APHA

Abstract #55723

Judith M Graber, MS, Nancy Sonnenfeld, PhD, Margaret A. Parsons, MD, MPH, and Kathleen D. Askland, MD, MA. Maine Bureau of Health, Key Plaza, 8th Floor, 11 State HouseStation, Augusta, ME 04333

The Maine Bureau of Health and Comprehensive Cancer Consortium assessed using BRFSS data to address the early detection goals of increasing the proportion of women appropriately screened for cancer of the breast and cervix in this rural, predominantly white (>96%), state. Using 1997-2000 data, we assessed associations between demographic characteristics and financial barriers to care with: having a Pap. test in the past 3 years for age >18 (with a uterus) and having a mammogram in the past 2 years for age >40. Logistic regression modeling followed univariate analysis. Multivariate analysis excluded insurance status and children in household for age >65, both rare events. Positively associated (p>0.05) with both outcomes for ages <65 were: younger age, having insurance, higher education, higher household income, cost as a barrier to care, employment, a child <12 in the household (mammogram only) and being married/couple (Pap. only). For age >65 younger age, higher income and marital status were significant. Final multivariate models included for 18-64: higher household income; having insurance, older age, married/couple (Pap. only) and employment (mammogram only); for >65: income and age. Surprisingly, Hispanic ethnicity and population density were not significant in any analysis. Small numbers precluded evaluating race. BRFSS is a useful tool for assessing population cancer screening patterns in Maine. Programs designed to increase breast and cervical cancer screening rates should consider health insurance status, age and martial status (for age <=65) of their target population. Other methods should be explored to understand screening in Maine’s non-white population.

Learning Objectives:

• To understand how epidemiological analysis of BRFSS data can help guide cancer prevention programs at the local level.
• To understand predictors of appropriate screening for cancer of the cervix and breast in a large rural state.
• To understand the limitations of using large data sets to help guide program implementaion.

Keywords: Access to Health Care, Cancer Screening

Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.