Knowledge of and enrollment in low cost or free mammography screening programs in two underserved west-side Chicago communities

Background: In Chicago, Black women are 62% more likely to die from breast cancer and Hispanic women are more likely to be diagnosed at later stages than White women. State programs are available to provide low cost or free mammograms, along with follow-up diagnostic and treatment services, to ensure access for uninsured and underinsured women. However, disparities persist and it is unclear whether such programs are meeting this need.

Methods: Using venue-based sampling methods, 2,056 women 40 yrs and over were surveyed about various breast health topics in two minority communities on Chicago's Westside. One purpose was to understand the level of awareness and utilization of these State programs.

Results: 39% of the overall sample and 40% of the uninsured (n=566) women had heard of the State program. Those with more education and higher incomes were more likely to have heard of the programs. Only 8% (n=44) of uninsured women were enrolled in the programs. Participants who reported having received mammogram referrals (p<0.001) and reported more than one preventive service (p<0.01) were more likely to be enrolled in State programs. They were also more likely worried about breast cancer (p<0.0001) or had fewer barriers to obtaining mammograms services (p<0.01). Of program enrollees, 93% reported having a biennial mammogram.

Conclusion: Awareness of free and low-cost programs to access breast cancer screening is generally low and enrollment is very low. Such programs should put greater effort into reaching women most in need and making enrollment simpler.