Introduction

Breast cancer is the second most common cancer among women in the United States, and about 1 in 8 women (about 13%) will develop invasive breast cancer in their lifetime. Breast cancer is the leading cause of cancer death in Hispanic women compared to non-Hispanic white women, with those in rural/border areas having a higher incidence and more likely to be diagnosed later than non-Hispanic white women or women in urban areas. BEST Program is a comprehensive multi-component, bilingual, culturally tailored, evidence-based intervention designed to reduce the burden of breast cancer among uninsured women in El Paso, West Texas, and South Texas counties.

BEST Program was initially started in 2014 and funded by the Cancer Prevention Research Institute of Texas (CPRIT) to address breast cancer screening barriers and to provide screening services in El Paso and Hudspeth counties. The BEST 2 program (2018-2021) expanded on the BEST Program, designed to provide new components of breast cancer education, navigation, and screening services. BEST 3 Program is a continuation of the BEST service delivery program that aims to expand services and implement enhanced breast cancer screening services in additional West and South Texas counties.

The overall Program goals include: 1) deliver culturally tailored, theory-based breast bilingual cancer education to all populations; 2) outreach through community health workers and new social media; 3) provision of no-cost testing to eligible women; 4) expand mammography network in external counties through clinic-based and community-based strategies; 5) and patient navigation to facilitate screening, diagnosis, health insurance coverage, PCP access, and cancer treatment.

Methods

BEST Program is an evidence-based, culturally tailored breast cancer screening intervention that provides community outreach, education, navigation, screening, and diagnostic services to eligible women in El Paso, West Texas, and South Texas counties. The program eligibility criteria include: 1) women aged 50-75 years; 2) Texas address; 3) uninsured or underinsured; 4) and due for screening (no mammogram in the past two years).

Results

To date, 6,638 women have been recruited, with a mean age of 57.4 years; 5.69% (n=378) had never had a mammogram, and 33.83% (n=2246) had a mammogram greater than three years previously. So far, 94.3% (n=6260) have completed screening, and 2,282 completed diagnostic tests (740 diagnostic mammograms,1,322 ultrasounds, and 210 biopsies). Sixty cancers have been diagnosed and navigated into treatment. Through the high risk referral system, 110 women were identified and referred to El Paso Breast Care Center for evaluation, and 20 completed BRCA testing and received genetic counseling.

Conclusion

BEST Program has been highly successful in helping women in need of breast cancer screening services. Findings from our previous grant cycles have indicated that our culturally tailored health education and free screening and diagnostic services have increased the rates of breast cancer screening completion in El Paso, West, and South Texas, which aims to reduce the burden and cancer disparities in the border region.