Roberta Guerrero heard that mammograms were expensive. The Spanish-speaking, 45-year-old mother of four also thought the breast cancer screening would be difficult to schedule around her busy life and her job as a fruit packer in Adams County.
But she had a niece who had found a lump in her breast, so she knew that she needed to be mindful of the risks of breast cancer.
Then Roberta heard from Family First Health in Gettysburg, her medical provider, that she could get a mammogram at no out-of-pocket cost to her through a program supported by WellSpan Gettysburg Hospital and the Adams County Breast Cancer Coalition. And she also learned she could get it done later in the afternoon on WellSpan’s mobile mammography motor coach when it stopped at a nearby apple-growing co-op in Adams County. Roberta scheduled her very first mammogram this summer and the results were clear.
“It was perfect because I can’t go to an appointment in the morning,” Roberta said, speaking through WellSpan Community Health and Engagement educator and interpreter Yeimi Gagliardi. “It was a good experience.”
The mobile mammography coach – which looks like a giant blue and pink bus and takes advanced breast cancer screening directly to where people live and work – is just one way that WellSpan is working on reducing inequities in breast cancer screening rates among different demographic groups.
WellSpan began addressing these discrepancies after digging into its electronic health record last year, to examine screening rates among different racial groups and design ways to improve its outreach to underserved communities. This is part of WellSpan’s vision to be a trusted partner committed to improving access to care to all patients it serves.
What the health record revealed was that white women had a screening rate of 71 percent, as compared to 69 percent for Black women, and 70 percent for Hispanic women in November 2021. After WellSpan worked on improving rates, rates rose for all groups, increasing to 75 percent for white women, 74 percent for Black women, and 76 percent for Hispanic women by June 2022.
“One of the few things we can do to improve survivability with late-stage cancer is to diagnose it early,” said Dr. Carlos Roberts, the vice president and chief medical officer of women’s and children’s services at WellSpan, who oversaw the breast cancer screening project. “We can have a better outcome if we find the cancer sooner rather than later.”
Roberts has a grandmother, aunt, and another close relative who all died from breast cancer, and his sister also battled it. For him, this work was personal.
“Each of these patients is someone’s aunt, someone’s grandmother who, if we get this right, has more time they can spend with their other family members,” he said. “That’s what this work means to me.”
Here are some specific things WellSpan is doing to increase mammogram rates:
Focus groups revealed that some Hispanic patients mistakenly thought that most mammograms found cancer, and so they were avoiding the screening, fearing the disease. WellSpan set up meetings with Hispanic patients, using Spanish interpreters, to demystify the test and explain that, in fact, most screenings show no cancer. However, the test is important because the main goal is to catch any disease early so it can be treated earlier and help patients live healthier lives.
- Address financial barriers.
WellSpan is working to more quickly identify patients who qualify for either Medicaid and Medicare and help them sign up for the insurance because the two federal insurance programs cover 100 percent of the cost of an annual screening mammogram. For patients who do not qualify for those programs, and do not have health insurance, WellSpan is working to connect them to financial resources to cover the cost, like the Adams County program Roberta used. WellSpan also received a grant from Capital Blue Cross to help uninsured women receive screening mammograms on the mobile mammography coach. This grant allowed 50 women to get a screening in the last year.
- Make it easier to schedule a mammogram.
WellSpan uses its electronic health record to identify patients who are due for a mammogram, and then sends them a reminder message via MyWellSpan, the online portal for patients. The message provides a link to easily schedule the test.
- Make it easier to get a mammogram.
In its first year, the mobile mammography coach provided mammograms to almost 600 women at 70 screenings at sites including a library, community centers, and local companies.
The screenings were held in areas where women do not always have easy access to a mammogram, including Delta, a town of less than 800 people in southern York County, close to the Maryland border; Georgetown, a hamlet in the rolling farmland of Lancaster County; and an apple growers’ co-op in in Peach Glen, a small community in northern Adams County where Roberta got her mammogram. The bus also raised awareness by holding tours and sharing information about breast cancer at events that included a women’s motorcycle rally.
To schedule your appointment or see about hosting the mobile mammography coach in a community-based location, visit https://www.wellspan.org/programs/womens-health/breast-care/mobile-mammography/
To learn about other ways WellSpan lives its vision to be a trusted partner to our community, visit https://www.wellspan.org/about/wellspan-in-the-community/.