Breast Cancer Screening Trends among Lower Income Women of New York: A Time-Series Evaluation of a Population-Based Intervention

Objective This study aimed to compare the screening rate trends of mammography among New York State's lower-income women and the higher-income women from 1988 to 2010, and evaluate the potential influence of New York State's Breast Cancer Early Detection Program (introduced in 1994) on the mammography use rates of lower-income women. Materials and Methods Lower-income women are defined as women aged 40 and over whose household income is lower than 250% of the single member household federal poverty level (FPL) in the year that they participated in the survey. Higher-income women are defined as women aged 40 and over whose income is greater than 250% of the five-person household FPL. Data were obtained from the Behavioral Risk Factor Surveillance System. Interrupted time series analysis was conducted to examine screening rates before and after the launch of the Breast Cancer Early Detection program. Results Among the lower-income women, the pre-intervention mammography screening rate significantly increased by an average of 15.21% every two years. However, after implementation of the Breast Cancer Early Detection Program, this rate of increase significantly slowed (slope change=-13.67, p=0.00016). The lower-income women and the higher-income women experienced a similar trend change after the intervention started. Conclusion This study found limited evidence that the Breast Cancer Early Detection Programme significantly contributed to the state-wide increase in mammography screening rate among lower-income women from 1988 to 2010. Future studies should examine the influence of structural and individual barriers inhibiting uptake of mammography screening among lower-income women.