Breast Self-Examination in Women in Two Primary Care Settings: An Evaluation of the Impact of Insurance Status

Abstract

Breast cancer is one of the most common cancers diagnosed among women in the United States. Screening tools available for breast cancer detection include breast self-examination (BSE), clinical breast examination, and mammography. Various studies have indicated that women may inconsistently perform BSE. This investigation evaluated the potential impact of insurance status on BSE. Women with health insurance receiving primary healthcare at a health maintenance organization (HMO) and women without health insurance receiving primary healthcare at a free clinic completed anonymous questionnaires that obtained information about the frequency of BSE performance, whether instruction was given about performing BSE, age at learning BSE, and confidence in performing BSE. One hundred fifty-five (82%) of 200 questionnaires at the HMO and 92 (92%) of 100 questionnaires at the free clinic were completed. Thirty-five percent of women (32% at the HMO, 39% at the free clinic) reported performing BSE. There were no significant differences in the rate of monthly BSE, receiving instruction about performing BSE, age at learning BSE, or confidence in performing BSE in women at the HMO and free clinic. Insurance status did not affect BSE. However, further study is needed to evaluate factors that potentially influence performance of BSE and could encourage compliance with BSE recommendations.