Let’s Get Screened is a three-part series on the Abramson Cancer Center (at the Hospital of the University of Pennsylvania, Penn Presbyterian Medical Center and Pennsylvania Hospital)'s efforts to bring breast, colon and lung cancer screenings to residents of our community who most need them.
Increasing Access to Mammograms
Church is where we pray. But many churches in the Greater Delaware Valley offer more than religion. Enon Tabernacle Baptist Church is one.
A fall gathering at the church drew over 200 women who have had breast cancer. An invitation to “bring a friend” resulted in more than 300 attendees. Those who came learned about breast health, cancer prevention and, thanks to a Penn outreach program, some made plans to have a free mammogram.
Since 2014, the Penn Medicine Breast Health Initiative (PMBHI) has provided free mammograms to 2,130 women in the region. A new grant from Brander Beacons Cancer Research (BBCR) is helping the program reach even more.
Strength in Breast Screening
A mammogram is a special X-ray of the breast. It is used to screen for breast cancer. Breast cancer is the second leading cause of cancer death among women in the Greater Delaware Valley. Pennsylvania has one of the highest breast cancer death rates in the country. These facts sound bleak but they don’t tell the whole story.
Cancer research moves at a rapid pace. New and better drugs enter the market. Screenings improve. 3-D mammography, available at Penn, offers sharper images than ever before. Screening leads to early detection. When breast cancer is found early, treatment is more likely to succeed.
While guidelines vary, doctors often talk with women about screening starting around age 40. For many women, a first or even second mammogram is a big step. The step becomes a leap for women without health insurance. Numbers highlight the gap. According to the Centers for Disease Control, 30 percent of women over 40 in the U.S. have not had a mammogram within the past two years. This number jumps to 70 percent for uninsured women.
The Penn program aims to help women take that step. It provides free breast cancer screenings and diagnoses to women ages 40 to 64 with no or limited health insurance.
Carmen Guerra, MD, MSCE, FACP, Ruth C. and Raymond G. Perelman Professor in Internal Medicine, and Ari Brooks, MD, Professor of Clinical Surgery, launched PMBHI in 2014. Funding comes from the Pennsylvania Department of Health’s (PA DOH’s) Healthy Woman Program. The Susan G. Komen Foundation also covers patient costs.
Navigating to Better Breast Health
A health navigator is key to the program’s success. Navigator Emily Verderame, MPH, works with women to schedule and keep appointments. She describes the procedure, its value and talks through concerns with patients. If cancer is found, she helps women enroll in health insurance and starts them on the road to treatment.
Verderame says that many women are surprised and grateful to learn of the program. Others take more convincing. They “feel fine” and don’t understand why the screening is needed.
Galina Kostanda, a local artist says, “This program is a miracle. I’ll never forget how the kindness and generosity of others has helped me and my family.” Kostanda is among 33 women treated for breast cancer after the free screening revealed a mass.
Insurance is not the only barrier women face. Some don’t speak English well or at all. Others need help with transportation or a more convenient location. The program offers translation, multiple sites and transit. Language services are vital. More than half of the women (55 percent) are non-English speakers. Most (80 percent) speak Spanish.
Some who sign up have not seen a doctor in recent years or ever. PMBHI opens a door for these women. Many go on to schedule other screenings or check-ups. Some return in future years for mammograms.
Power in Partnerships
The goal is to screen as many women as possible. This mission takes staff outside of the hospital into the community. Outreach offers a chance to teach women about breast cancer risk and the value of mammograms. Each year, more women use the free service.
In 2018, women obtained 437 screening mammograms, 221 diagnostic mammograms, and 37 breast biopsies. These numbers will likely be higher for 2019. The first half of the year alone saw 291 screening mammograms, 145 diagnostic mammograms, and 37 breast biopsies.
The program works with over 15 community agencies to recruit women. The BBCR grant provides an added boost to reach even more communities.
The new grant supports three workshops. Each targets a different group. The Enon Tabernacle event, held at the mostly African-American church, was first in the series. Future activities will focus on Philadelphia’s Asian and Hispanic/Latina communities. Events take place at familiar sites like churches and community centers. They draw new faces who might not otherwise learn about free screenings.
Dr. Guerra says, “Since uninsured women are not showing up to health systems requesting a mammogram, this program relies on many community partners that serve the health and non-health needs of these women. We also rely on the many organizations that fund our work including the PA DOH, and the Komen and Brander Beacons Cancer Research Foundation. We are grateful to our partners that have allowed us to create a safety network for women and honored to serve the diverse women in our communities.”
Read part 1 on colon cancer screening
Read part 3 on lung cancer screening