Community-based Interventions to Improve Breast and Cervical Cancer Screening: Results of the Forsyth County Cancer Screening (FoCaS) Project

• Published in: Cancer epidemiology, biomarkers & prevention biomarkers & prevention, 1999-05, Vol.8 (5), p.453-459
• Main Authors: PASKETT, E. D, TATUM, C. M, D'AGOSTINO, R. JR, RUSHING, J, VELEZ, R, MICHIELUTTE, R, DIGNAN, M
• Format: Article
• Language: English
• Subjects: Adult; African Americans; Aged; Biological and medical sciences; Breast Neoplasms - ethnology; Breast Neoplasms - prevention & control; Community Health Services; Cross-Sectional Studies; Female; Follow-Up Studies; Gynecology. Andrology. Obstetrics; Health Behavior; Health Knowledge, Attitudes, Practice; Health Promotion - methods; Humans; Logistic Models; Mammary gland diseases; Mammography; Mass Screening - standards; Medical sciences; Middle Aged; North Carolina - epidemiology; Papanicolaou Test; Poverty; Prevention and actions; Public health. Hygiene; Public health. Hygiene-occupational medicine; Specific populations (family, woman, child, elderly...); Tumors; Uterine Cervical Neoplasms - ethnology; Uterine Cervical Neoplasms - prevention & control; Vaginal Smears
• ISSN: 1055-9965; 1538-7755

The FoCaS (Forsyth County Cancer Screening) Project was one of six projects funded by the National Cancer Institute “Public Health Approaches to Breast and Cervical Cancer” initiative. The goal of this project was to improve the use of breast and cervical cancer screening among low-income, predominately African-American, women age 40 and older. Strategies implemented in the intervention city included public health clinic in-reach strategies (chart reminders, exam room prompts, in-service meetings, and patient-directed literature) and community outreach strategies (educational sessions, literature distribution, community events, media, and church programs). Baseline and follow-up data from independent cross-sectional samples in both the intervention and comparison cities were used to evaluate the effects of the intervention program. A total of 248 women were surveyed at baseline, and 302 women were surveyed 3 years later at follow-up. The proportion of women reporting regular use of mammography increased (31 to 56%; P < 0.001) in the intervention city. In the comparison city, a nonsignificant (ns) increase in mammography utilization was observed (33 to 40%; P = ns). Pap smear screening rates also improved in the intervention city (73 to 87%; P = 0.003) but declined in the comparison city (67 to 60%; P = ns). These relationships hold in multivariate models. The results suggest that a multifaceted intervention can improve screening rates in low-income populations. These results have important implications for community-based research and efforts in underserved populations.