Successful Intervention Improved Breast Cancer Screening Rates Among Latinos

A new study by researchers at the Kaiser Permanente Center for Health Research has found that visits by trained community health workers (promotoras) improved screening rates for breast cancer among Latino women. The most common cancer diagnosed in women in the United States, breast cancer is also the leading cause of cancer-related death in this minority population.

In their paper published in Cancer Epidemiology, Biomarkers and Prevention, the authors write that their Multilevel Intervention to Increase Latina Participation in Mammography Screening study (¡Fortaleza Latina!) was designed to evaluate the impact of clinic- and patient-level programs on breast cancer screening in Latino women in the state of Washington who sought care at a safety net health center. Five hundred and thirty six Latino women, 42 to 74 years old, who had a primary care clinic visit in the previous 5 years and had not obtained a mammogram in the previous 2 years were enrolled in the study. Eighty percent of the women were born in Mexico, and 92% preferred speaking Spanish; less than 50% were employed, and the majority earned less than $20,000 a year. Most had completed less than 8 years of formal education, and nearly 75% lacked health insurance.

The 2-arm study had a control arm of usual care and the intervention arm, which included a promotora-led, motivational interviewing intervention that included a home visit and telephone follow-up. Early intervention could significantly impact the Hispanic population who have been documented to present with more advanced stage disease than non-Hispanic whites. Subsequently, treatment outcomes in these patients are worse since the advanced disease is usually more resistant to treatment.

The Kaiser study found that promotora visits improved the rate of screening mammography by more than 8% (19.6%) compared with the control group (11.0%) that received usual care (P <.001). The authors believe that the interaction with the health worker had a much bigger role to play in the observed results, because simply providing additional mammography services via a mobile mammography unit did not influence screening rates.

In an associated press release, lead author Gloria Coronado, PhD, a cancer disparities researcher at the Kaiser Permanente Center for Health Research in Portland, Oregon, said, “Promotora visits are essential in educating Latina women about the importance of breast cancer screening. Our study showed a modest, but significant increase in screening rates. We are encouraged by these findings, and must continue to involve patients, clinics and communities in efforts to further reduce the inequity in breast cancer screening.”

Reference

Coronado GD, Beresford SAA, McLerran D, et al. Multilevel intervention raises Latina participation in mammography screening: findings from ¡Fortaleza Latina! Cancer Epidemiol Biomarkers Prev. 2016;25:584. doi:10.1158/1055-9965.EPI-15-1246.