Mobile Screening Mammogram Program Serves Vulnerable Population

The University of Tennessee Medical Center's (UTMC) Breast Health Outreach Program (BHOP) provides mobile mammography breast cancer screening to its 21-county service area. Desiring reductions to barriers for appropriate screening, BHOP utilization is regardless of a woman's insurance status. Hypothesis: there is a difference between insured/uninsured women. Eight variables (see table) were analyzed including counties with stationary mammography equipment (SME).

Data was collected from the UTMC's BHOP mammography screenings' prospectively maintained database from 2008-2022 (n=44,156). The statistical analysis methods included frequencies, cross-tabulation tables, chi-square, unadjusted odds ratios (OR) with 95% confidence intervals and logistic regression. Statistical analysis was performed using SPSS Version 29.

Of women screened on the MMU, 36,643 (83.0%) were insured while 7,513 (17.0%) were uninsured. Uninsured had significantly higher odds of abnormal results (OR=1.20, 95% CI 1.05–1.37, p=0.006), first mammogram encounter (OR=2.37, 95% CI 2.18-2.56, p<0.001), minority race/ethnicity status (OR=3.08, 95% CI 2.88-3.30, p<0.001), living in a rural county (OR=1.43, 95% CI 1.36-1.50, p<0.001), and greater than 1 year since their last mammogram (ORs ranging from 1.20-3.57 for increasing time, p<0.001). After age 50, the odds of being uninsured decreased significantly (ORs ranging from 0.91 to 0.04, p<0.001). Uninsured had significantly less odds of being married (OR=1.47, 95% CI 1.40-1.55, p<0.001), or living in a county with SME (OR=2.18, 95% CI 2.04-2.33, p<0.001).

Analysis showed that uninsured women are less likely to receive screenings at frequent intervals, have abnormal findings, not receive previous mammograms, live in a rural county, and not live in a county with SME. After age 50, the odds of being uninsured decrease. Uninsured are more likely to not be married, and a minority. This data leads us to recommend targeting uninsured women.