UICC World Cancer Congress 2006

Objective: Women with low functional health literacy face numerous barriers to completing the breast and cervical cancer screening continuum – clinical breast exam, mammogram, Pap test, any necessary follow-up, and returning for annual mammograms. A collaborative research project is combining survey data with clinical outcomes data to examine the links between functional health literacy and cancer screening and follow-up.

Methods: A total 800 Black and Latina women attending appointments for cancer screening at two NBCCEDP sites in New York City will respond to a questionnaire and complete the TOFHLA or TOFHLA-S. Programmatic variables being studied include the availability of “one-stop” combined breast and cervical screening on weekends and case management.

Results: In the first two months of the project, 110 Spanish-speaking Latinas (age 40-75) were enrolled, with 59 women eligible for Pap testing. Among these 59 women, 35% had inadequate and 14% marginal health literacy levels in Spanish. Almost all (93%) were foreign-born, predominantly in the Dominican Republic. Within 1 month after the initial screening mammogram, 60% of eligible patients received a Pap test. Patients seen as part of the combined weekend screening program were almost 6 times more likely to obtain necessary Pap testing (OR 5.91, 95%CI: 1.52-18.52). In this population of Latinas with inadequate and marginal functional health literacy in Spanish, offering combined screening on weekends significantly increases the probability that a woman will receive complete screening. As recruitment continues, the study will examine the independent effect of health literacy on completion of breast and cervical cancer screening.