An evaluation of the Siteman Cancer Center Breast Health Center mammography outreach program

Background: Despite the wide use of mobile mammography in outreach efforts there is a dearth of literature on effectiveness, best practices, and the evaluation of mobile mammography outreach programs. An outreach registry of patients serviced by the Breast Health Center (BHC) was created for program evaluation and planning purposes. Registry includes medical record data and responses to a brief questionnaire completed at each visit. Methods: We evaluate the BHC outreach program to determine, population served, barriers to mammography, and effectiveness of mobile mammography efforts. We examined data from the first screening visit of women enrolled in the BHC registry between 2006 and 2011. Data are examined by point of care (van/onsite, and urban/suburban/rural). Results: In the six year period 9,079 women were enrolled in the registry; 33% white, 54% black, 4% Hispanic and 8% other race/ethnicity. The majority of women are uninsured (74%), were screened on the van (83%), have an annual income less than $20,000 (87%), reside in St. Louis City (44%) or County (40%); over a quarter had more than high school education (27%), 24% reside in one of the eight high breast cancer mortality zip codes, and 5% in the rural bootheel region of Missouri. Discussion: Despite receiving free services most women reported cost as a major barrier to mammography. Without this type of outreach service most of these women reported they would not have a mammogram next year. Additional barriers include being afraid suggesting that breast health education may be needed to increase screening rates.