Terry C. Davis|Connie L. Arnold|Michael S. Wolf|Charles L. Bennett|Dachao Liu|Alfred Rademaker
Joint breast and colorectal cancer screenings in medically underserved women
Louisiana State University Health Sciences Center Shreveport
breast colon cancer screening rural community clinics underusedto evaluate effectiveness costeffectiveness alternative interventions designed promote simultaneous screening breast colon cancer community clinicsa 3arm quasiexperimental evaluation conducted may 2008august 2011 8 federally qualified health clinics predominately rural louisiana baseline screening rates reported clinics 10 breast cancer using mammography 12 colon cancer using fecal occult blood test fobt 744 women aged 50 years older eligible routine mammography fobt recruited combined screening efforts included enhanced care health literacyinformed education education alone health literacyinformed education nurse support nurse supportpostintervention screening rates completing tests 281 enhanced care 237 education alone 387 nurse support adjusting age race literacy patients received nurse support 221 times likely complete screenings received education alone 95 confidence interval ci 112438 p 023 incremental cost per additional woman completing screenings 3987 education nurse support education alone 5987 enhanced carethere differences 3 arms sociodemographic characteristics literacy previous screening history variables significantly different arms adjusted therefore adjustments key variables age race literacy made statistical analyses limitations related generalizability resultsalthough joint breast colon cancer screening rates increased substantially existing baseline rates 3 arms completion rate tests modest nurse support telephone followup effective however likely cost effective affordable clinics limited resources