October is Breast Cancer Awareness Month, a time to join together and call attention to the effects of breast cancer as well as its impact on the most vulnerable populations across the country. Breast cancer is the most common cancer in women. According to a National Cancer Institute report, an estimated 287,850 women will be newly diagnosed with breast cancer in the United States, and an estimated 43,250 women are projected to lose their lives from it this year alone.¹   

 In Colorado, approximately 28,480 women will receive a breast cancer diagnosis this year. 1 in 7 women will receive a breast cancer diagnosis in their lifetime.  There are an estimated 61,000 breast cancer survivors living in Colorado (as of 2016). ⁵

 Breast Cancer and Low-SES Risk Factors

Upon closer examination, breast cancer incidence (new cases), survivorship and mortality rates continue to vary or differ significantly by socioeconomic factors (income, education, health insurance coverage) as well as geography within states, across regions and nationwide. Cancer survival or survivorship is typically described in terms of relative survival, which is a measure of life expectancy among cancer patients compared to that among the general population of the same age, race, and gender.²

As with most cancers, populations with low socioeconomic status (SES) characteristics, such as low income, low levels of education, and lack of or inadequate health insurance coverage, may have additional risk factors for breast cancer. Reports reveal that cancer mortality rates are higher in counties with high levels of current poverty. In addition, poverty with persistent poverty face social, structural (including transportation) and behavioral challenges that may contribute to residents becoming more vulnerable to cancer risks or higher rates of cancer disparities associated with a late-stage or advanced stage cancer diagnosis.³

To reverse the trends impacting vulnerable populations (including low-income women), Summit Community Care Clinic has partnered with the Colorado Department of Public Health and Environment (CDPHE) to offer low-income and uninsured women free breast cancer screenings. Through this partnership, low-income and uninsured women may receive a mammogram at little to no cost. Many health insurance programs, including Medicaid, cover mammograms at no cost. 

Populations with low-SES characteristics often experience barriers to breast cancer screening that could detect breast cancer early when it is easier to treat. Across the country, an estimated 65% of women aged 45 and older were up to date with American Cancer Society recommendations for breast cancer screenings in 2019.⁴ However, breast cancer screening rates are not the same for all women. For instance, only 36% of uninsured women aged 45 and older are up to date on mammograms. Women who have less education or who have recently immigrated to the United States are also less likely to be up to date on breast cancer screenings. At Summit Community Care Clinic, as of October 2022, 45% of women aged 45 and over are up to date with mammography screenings overall and approximately 42% of women aged 45 years and older who fall below the 200% Federal Poverty Level are up to date with mammogram screenings.

To improve the breast cancer health of women overall (including low-income women) in the state of Colorado, Summit Community Care Clinic helps patients keep track of when they are due for a mammogram at every appointment, most often at annual exams.  Partnering with Summit Medical Center, the Care Clinic refers patients who need a mammogram.  Summit Medical Center performs the test and sends the Care Clinic the results to review with the patient.

At Summit Community Care Clinic, we remain committed to improving the breast cancer health of women (including low-income women) throughout the year.

References:

1.     National Cancer Institute (NCI) Cancer Stat Facts: Female Breast Cancer accessed at:

https://seer.cancer.gov/statfacts/html/breast.html

2.     American Cancer Society. Cancer Facts & Figures 2022. Atlanta: American Cancer Society; 2022.

3.     Moss JL, Pinto CN, Srinivasan S, Cronin KA, Croyle RT. Persistent Poverty and Cancer Mortality Rates: An Analysis of County-Level Poverty Designations. Cancer Epidemiol Biomarkers Prev. 2020 Oct;29(10):1949-1954. doi: 10.1158/1055-9965.EPI-20-0007. PMID: 32998949; PMCID: PMC7534551.

4.     American Cancer Society. Cancer Facts & Figures 2022. Atlanta: American Cancer Society; 2022.

 Resources (National):

1.     Centers for Disease Control and Prevention (CDC) National Breast and Cervical Cancer Early Detection Program (NBCCEDP) at: https://www.cdc.gov/cancer/nbccedp/screenings.htm

2.     National Cancer Institute (NCI) Cancer Support Services Directory at:

https://supportorgs.cancer.gov/home.aspx?js=1

3.     National Football League (NFL) and American Cancer Society (ACS) Launch New Cancer Screening Platform as Part of Crucial Catch Initiative

https://operations.nfl.com/updates/football-ops/nfl-and-acs-launch-new-cancer-screening-platform-as-part-of-crucial-catch-initiative/

4.     Affordable Care Act (ACA) Preventive Care Benefits for Women:

https://www.healthcare.gov/preventive-care-women/

Resources (State/County/ Partnership):

5.     Colorado Cancer Coalition Breast Cancer Stats in Colorado at:

https://www.coloradocancercoalition.org/end-cancer/breast-stats-in-colorado/

Colorado Cancer Coalition