Individual and Catchment Area Factors Associated With Breast and Cervical Cancer Screening Within the Military Health...

Area of Science:

• Oncology
• Public Health
• Health Services Research

Background:

• Early detection of breast and cervical cancers through screening improves patient survival.
• Screening rates within the Military Health System (MHS) exhibit variability.
• Understanding these variations is key to optimizing cancer care within the MHS.

Purpose of the Study:

• To identify individual-level and catchment area-level factors associated with breast and cervical cancer screening rates in the MHS.
• To analyze variations in screening for breast and cervical cancers.
• To inform strategies for enhancing cancer screening within the MHS.

Main Methods:

• Utilized 2007-2019 MHS Data Repository data.
• Examined associations between screening rates and demographic, military, and healthcare utilization factors.
• Employed univariate and multivariate statistical analyses.

Main Results:

• Observed 1-year mammography screening rate of 45.6% and 2-year rate of 65.7%.
• Observed 1-year Pap test rate of 30.5% and 2-year rate of 51.9%.
• Higher screening rates for older, married individuals, senior ranks, and non-Hispanic Black women for breast cancer; younger, unmarried, junior ranks, and non-Hispanic Black women for cervical cancer. Higher rates for both in areas with more private sector care.

Conclusions:

• Higher screening in areas with more purchased care requires further investigation.
• Individual factors associated with breast and cervical cancer screening differ, suggesting tailored policies.
• MHS features like universal coverage may reduce racial/ethnic disparities in screening.