Cancer screening among uninsured patients accessing care at a community health clinic

Context: Brother Bills Helping Hand Clinic provides community services such as job training, grocery stores, mental health counseling and free medical services to the underserved community. The community center also offers a day-time clinic equipped with laboratory services.

Objective: To assess history of cancer screening and modifiable risks associated with cancer among patients who access care at BBHH.

Study Design and Analysis: A Redcap survey to assess cancer screening history, demographics & healthcare literacy and distributed via text between May-June 2023.

Setting or Dataset: Data from survey

Population Studied: There are nearly 1000 patients who access medical care at the medical clinic at BBHH. Most patients are working, female, uninsured and Hispanic.

Intervention/Instrument: Anonymous, text-based survey in Redcap in English and Spanish

Outcome Measures: History of cancer screening, modifiable risks for cancer, and demographics

Results: 95 patients completed the survey. 78% were female, 22% were male, and the vast majority (99%) were Hispanic. 20% had some form of tobacco use.

The proportion of BBHH patients who were eligible and screened for colorectal cancer (N=50); breast cancer (N=64) or cervical cancer (N=74) was 20%, 98% and 84%, respectively. Of the 63 eligible patients screened for breast cancer, 65% had a mammogram within 1 year. For breast cancer screening, of the 64 patients screened, 78% (N=46) did not know their results, and 9% (N= 5) had not followed up on their screening results. For cervical cancer screening, 80% (N=48), were aware that they had normal results.

Conclusions: This assessment confirms the disparities in cancer screening among uninsured patients at BBHH. The low rates of colorectal cancer screening present an opportunity to work on cancer awareness and risk factor prevention. In addition, better mechanisms should be implemented to address the lack of follow up on breast cancer screening. 20% of patients had a form of tobacco use in their lifetime, nearly twice the national tobacco use rate of Hispanic patients. Programs should focus on developing smoking cessation programs.

Learning Objectives: Discussing lower colorectal cancer screening rates, differences in patients’ knowledge about their results between cervical and breast cancer & the need for smoking cessation programs.

Research Category: Quality Improvement

Study Design: Voluntary survey, single center SRFC