Delivering breast and cervical cancer screening services to underserved women: Part I. Literature review and telephone survey.

Although breast and cervical cancer screening procedures have been shown to reduce morbidity and mortality, many women are not using these services. These women are likely to be older, of ethnic or racial minority, of low socioeconomic status, less educated, underinsured, or living in rural locations. Many breast and cervical cancer screening programs employ strategies to increase use. In order to identify and assess those strategies, we reviewed the literature and completed a telephone survey, altogether assessing 61 programs. Our study identified several strategies and found that not all strategies work for all women. Management systems directed to both patients and providers consistently are effective for most underserved women. Community-based outreach and integration of preventive services at the primary health care (PHC) site are effective strategies for both African American and Hispanic women. Use of mass media has been successful when targeted toward Hispanic women, but not when targeted toward African American women. Mobile units and integration of preventive services at PHC sites are effective strategies for elderly women. In many cases, a combination of strategies may be effective. Programs should employ strategies best suited to their target populations.