Improving Breast Cancer Screening Adherence Among Hospitalized Women

Background: More than a third of hospitalized women are both overdue for breast cancer screening and at high risk for developing breast cancer. The purpose of the study was to evaluate if inpatient breast cancer screening education, scheduling an outpatient mammography appointment before hospital discharge at patients' convenience, phone call reminders, and a small monetary incentive ($10) would result in improved adherence with breast cancer screening for these patients. Methods: A prospective intervention pilot study was conducted among 30 nonadherent women aged 50-75 years hospitalized to a general medicine service. Sociodemographic, reproductive history, family history for breast cancer, and medical comorbidity data were collected for all patients. Chi-square and unpaired t-tests were utilized to compare characteristics among women who did and did not get a screening mammogram at their prearranged appointments. Results: Of the 30 women enrolled who were nonadherent to breast cancer screening, the mean age for the study population was 57.8 years (SD=6), mean 5-year Gail risk score was 1.68 (SD=0.67), and 57% of women were African American. Only one-third of the enrolled women (n=10) went to their prearranged appointments for screening mammography. Not feeling well enough after the hospitalization and not having insurance were reported as main reasons for missing the appointments. Convenience of having an appointment scheduled was reported to be a facilitator of completing the screening test. Conclusion: This intervention was partially successful in enhancing breast cancer screening among hospitalized women who were overdue and at high risk. Future studies may need to evaluate the feasibility of inpatient screening mammography to improve adherence and overcome the significant barriers to compliance with screening.