Identifying screening barriers in an advanced breast cancer hotspot in Wilmington, DE

• Na'ja Stokes, Biological Sciences, Delaware State University

• Scott Siegel, Cawley Center for Translational Cancer Research, ChristianaCare

Identifying screening barriers in an advanced breast cancer hotspot in Wilmington, DE

Background:

Studies show that although Black and White women have similar rates of diagnosis for breast cancer, Black women experience a 40% mortality rate. Previous research from the Helen F. Graham Cancer Center & Research Institute (HFGCCRI) identified a hotspot in Wilmington, Delaware, with higher-than-expected rates of advanced breast cancer. Given that routine mammography and engagement with primary care physicians (PCP) are critical components of early detection and improving screening rates, the present study aims to understand interactions with healthcare providers for patients from the Wilmington, DE advanced breast cancer hotspot.

Method:

Patient records (N = 23; 60.9% Black) were retrospectively reviewed from the HFGCCRI Cancer Registry and ChristianaCare Electronic Health Records system (EHR) for those who resided in the Wilmington hotspot. Demographic, clinical, screening history and method of diagnosis data were abstracted for each patient. Historical timelines were created that highlighted interactions with the healthcare system prior to the patient’s diagnosis. Historical timelines were created to determine similarities patients encountered during their interaction with the healthcare system and potential barriers were developed.

Result:

Patients (Mage = 52.5, SDage = 14.1) were diagnosed via Clinical/Symptomatic (60.9%) more than Screening (39.1%). Four common barriers to screening were identified: preventative care discussion not documented (39%), social determinants of health (30.4%), no PCP documentation (21.7%), and acute care health issues (17.4%).

Conclusions:

Findings suggest that preventative services may not be as accessible for patients living within the Wilmington hotspot. Lack of accessibility could be due to a variety of factors including socioeconomic barriers, housing insecurity or transportation challenges. Future directions should aim to develop initiatives to make preventative more accessible, interviewing patients to more thoroughly understand these barriers, and possibly discuss preventative services recommendations with PCPs.