An Interview with Catherine Strode
One out of every seven women in Colorado will develop breast cancer during their lifetime. That compares with a national statistic of one out of every eight women. Although more women are diagnosed with breast cancer in Colorado, fewer are diagnosed with advanced stage disease and fewer women die from the disease compared to national statistics. In a Needs Assessment study conducted over a diverse 22 county service area, Komen Colorado has identified the top barriers to care for women in the state.
Komen Colorado Study Identifies Barriers to Breast Health Care
One out of every seven women in Colorado will develop breast cancer during their lifetime. That compares with a national statistic of one out of every eight women. Although more women are diagnosed with breast cancer in Colorado, fewer are diagnosed with advanced stage disease and fewer women die from the disease compared to national statistics. In a Needs Assessment study conducted over a diverse 22 county service area, Komen Colorado has identified the top barriers to care for women in the state.
In an interview with Catherine Strode, the Director of Mission Programs for Komen Colorado, Toni Panetta, discusses those barriers and says ongoing advocacy is needed in Colorado to decrease disparities in populations experiencing more advanced disease diagnoses and higher mortality rates.
Does research show why the breast cancer rate is higher for women living in Colorado?
“We don’t have an explanation for why. That is why Komen Colorado will continue to advocate, certainly at the federal level and all opportunities at the state level, for increased funding into research to understand what it would be about Colorado that has that higher diagnosis rate. But it’s important to remember that the incidence of breast cancer diagnosis is attributable to a couple of things. In some cases, it may be indicative of more cancers. In other cases, it may be indicative of better access to detection. We might be in a situation in Colorado where, compared to the rest of the country or compared to other states, Colorado women have more access to screening technologies. They might be going more frequently for their mammograms. That’s part of why we don’t know why there’s that difference of one in seven Colorado women versus one in eight women nationwide. While we have more incidence of breast cancer being diagnosed in Colorado, we also have a higher survivorship rate compared to the rest of the country.”
What kinds of barriers to care does the data show?
“According to our Community Needs Assessment, the top barriers that have been recurring in those 22 counties include the cost of breast cancer care, or in some instances, the perceived cost of care. Individuals don’t have transparent information about what it will cost to receive: a clinical breast exam, a mammogram, a diagnostic test, chemotherapy, surgery, or radiation. We also know that barriers include having a lack of insurance. Contributing factors to the lack of insurance include the cost of premiums as well as not having the appropriate documentation status to qualify for various insurance programs that are offered. We have also been able to confirm that barriers include the location of the provider and the proximity an individual would have to travel to access care. That could include someone who works one or two counties away from their primary care facility or someone who does not have a primary care facility in their home county. When it comes to specialty care, we know that in Northeastern Colorado for example, someone who’s been diagnosed with breast cancer might need to travel upwards to 200 miles each way to access specialty services.”
Are the statistics of breast cancer higher in Colorado’s rural areas?
“What we are finding are variances in the likelihood of breast cancer being diagnosed at an advanced stage of the disease progression compared to areas of the state that have more facilities. We also see disparities in either stage of diagnosis or self-reported frequency of mammograms not just by geographical differences, but also, among income levels. We know from data that households earning below 200 and 250 per cent of the federal poverty level are reporting that they are having a mammogram less frequently than women who are above 200 per cent of the federal poverty level. We know that stage of diagnosis also tends to correlate with poverty income household levels. We also see data variances in screening frequency among women of color compared to their white counterparts.”
How is Komen Colorado advocating to decrease barriers?
“Komen Colorado continues to monitor barriers related to insurance coverage, like network adequacy, or transparency in cost sharing, or individuals who have insurance, particularly when it comes to prescription coverage. We know there is a lot of confusion when women and their families are shopping for insurance to figure out what their costs will be if they are currently undergoing treatment, or are breast cancer survivors, who are required to complete five or ten-year regimens of prescription medications to reduce the likelihood of recurrence. When people are shopping for insurance, they don’t always have accurate information about what a prescription will cost that they need to maintain.”
Catherine Strode is Advocacy Denver’s Communications and Policy Specialist. She holds a Masters degree in Public Administration with an emphasis in Health Care Policy. Catherine publishes Policy Perspective, featuring interviews with state policy makers on issues that affect the work and mission of Advocacy Denver.