Access to Care, Quality of Care and Cancer Screening in an African-American Medicare Population

Background: Using baseline data from the Cancer Prevention and Treatment Demonstration (CPTD), funded by the Centers for Medicare & Medicaid Services (CMS), we explored the influence of access to care and quality of care factors on cancer screening for African American older adults in Baltimore, MD.

Methods: We performed logistic regression analyses on 2,443 men and women for colorectal cancer screening and 1,184 women for breast cancer screening.

Results: Compared to beneficiaries without a regular provider, those with a regular provider are twice as likely to be current with colorectal cancer screenings (OR 2.14, 95% CI 1.42-3.23). Participants whose provider usually or always explains things clearly have increased odds of being current with screenings versus those whose providers never or seldom explain things clearly (OR 2.04, 95% CI 1.42-2.87). Women who have a usual source of care are three times as likely to be current with breast cancer screening compared to women without a usual source of care (OR 2.73, 95% CI 1.44-5.13). Women who report little or no problem finding a doctor are three times as likely to be current with mammograms and women who claim little or no problem with delays in healthcare are over twice as likely to be current with mammograms than those who cite challenges accessing services (OR 3.02, 95% CI 1.44-6.32; OR 2.25, 95% CI 1.01-5.02).

Conclusion: Our findings suggest that providing consistent access to a regular provider and improving physician communication improves cancer screening rates in African-American older adults.