title: Breast cancer screening of underserved women in the USA: results from the National Breast and Cervical Cancer Early Detection Program, 1998-2012.
abstract: OBJECTIVE
  To describe the number and proportion of eligible women receiving mammograms funded by the National Breast and Cervical Cancer Early Detection Program (NBCCEDP).
  
  
  METHODS
  Low-income, uninsured, and underinsured women aged 40-64 are eligible for mammography screening through the NBCCEDP. We used data from the NBCCEDP, the Current Population Survey, and Medical Expenditure Panel Survey to describe the number and proportion of women screened by the NBCCEDP and overall.
  
  
  RESULTS
  In 2011 and 2012, the NBCCEDP screened 549,043 women aged 40-64, an estimated 10.6 % (90 % confidence interval [CI] 10.4-10.9 %) of the eligible population. We estimate that 30.6 % (90 % CI 26.4-34.8 %) of eligible women aged 40-64 were screened outside the NBCCEDP, and 58.8 % (90 % CI 54.6-63.0 %) were not screened. The proportion of eligible women screened by the NBCCEDP varied across states, with an estimated range of 3.2 % (90 % CI 2.9-3.5 %) to 52.8 % (90 % CI 36.1-69.6 %) and a median of 13.7 % (90 % CI 11.0-16.4 %). The estimated proportion of eligible women aged 40-64 who received mammograms through the NBCCEDP was relatively constant over time, 11.1 % (90 % CI 10.2-11.9 %) in 1998-1999 and 10.6 % (90 % CI 10.4-11.9 %) in 2011-2012 (p = 0.23), even as the number of women screened increased from 343,692 to 549,043.
  
  
  CONCLUSIONS
  Although the NBCCEDP provided screening services to over a half million low-income uninsured women for mammography, it served a small percentage of those eligible. The majority of low-income, uninsured women were not screened.
authors.affiliation: Department of Health Policy and Management, Emory University, 1518 Clifton Road NE, Atlanta, GA, 30030, USA, david.howard@emory.edu.
authors.forename: David H
authors.initials: DH
authors.lastname: Howard
authors.forename: Florence K L
authors.initials: FK
authors.lastname: Tangka
authors.forename: Janet
authors.initials: J
authors.lastname: Royalty
authors.forename: Lucinda P
authors.initials: LP
authors.lastname: Dalzell
authors.forename: Jacqueline
authors.initials: J
authors.lastname: Miller
authors.forename: Brett
authors.initials: B
authors.lastname: O'Hara
authors.forename: Kristy
authors.initials: K
authors.lastname: Joseph
authors.forename: Kristy
authors.initials: K
authors.lastname: Kenney
authors.forename: Gery
authors.initials: G
authors.lastname: Guy
authors.forename: Ingrid J
authors.initials: IJ
authors.lastname: Hall
mesh_terms: D000368:Aged; D001943:Breast Neoplasms / Q000175:diagnosis*; D055088:Early Detection of Cancer / Q000379:methods*; D005260:Female; D006291:Health Policy; D006801:Humans; D008327:Mammography; D017057:Medically Uninsured; D008875:Middle Aged; D011203:Poverty; D011634:Public Health; D002583:Uterine Cervical Neoplasms / Q000175:diagnosis*