Breast cancer stage at diagnosis in a New Jersey cancer education and early detection site

Objectives: The National Breast and Cervical Cancer Early Detection Program provides free or low-cost screening to uninsured or underinsured women and has had positive results; however, only a few state programs have been evaluated. This study will provide a first snapshot of the effectiveness of the New Jersey program, by comparing stage at diagnosis for enrollees as compared with nonenrollees who received definitive treatment for breast cancer at the same academic medical center. Materials and Methods: A retrospective analysis of 5 years of breast cancer data abstracted from the Cancer Registry of a large urban hospital in the Northeast United States. Bivariate analysis and logistic regression were utilized. Results: One thousand forty women were screened for and diagnosed with breast cancer at this site; they were more likely to be racially (P<0.001) and ethnically (P<0.002) diverse as compared with nonenrollees. Enrollees were more likely to be symptomatic at diagnosis (P<0.001), and diagnosed at a late stage when compared with nonenrollees (odds ratio, 1.88; 95% confidence interval, 1.07-3.29). Conclusions: This national program was developed to serve low income, under and uninsured women who may otherwise have limited access to cancer screening services. It appears that many women enroll in this program needing diagnostic rather than screening services, after breast symptoms were noted. This finding helps to emphasize the fact that just providing free screening services is not enough to make up for the lack of a usual source of preventive care for low income and uninsured women.