Increasing Breast Cancer Screening in Pacific Islander Women

Jessica Stephens

Background: Breast cancer is the most commonly diagnosed cancer among women in the United States and remains the second leading cause of cancer-related death. Mammography screening reduces mortality and supports earlier, less intensive treatment; however, Pacific Islander (PI) populations experience increasing breast cancer incidence and persistent cultural, linguistic, and systemic barriers to screening. This quality improvement (QI) project was conducted at a federally qualified health center (FQHC) serving one of the largest PI communities in the Midwest. Purpose: The purpose of this QI project was to implement culturally tailored strategies to improve mammography adherence among eligible PI women, with the goal of increasing screening rates from a baseline of 32.35% toward the Health Resources and Services Administration Uniform Data System (UDS) benchmark of ≥ 47%. Methods: Guided by the Model for Improvement and Plan-Do-Study-Act cycles, this mixed-methods QI project targeted PI women aged 50-74 who had not received a mammogram within the measurement period. Interventions included in-language education and culturally tailored materials, outreach, and navigation support for coverage programs. Screening outcomes were evaluated using pre- and post-intervention UDS data. Qualitative feedback was obtained, and screening barriers identified included cost and insurance, transportation, language and literacy, fear of what the findings would show, and mobility and access concerns. Findings: This QI project demonstrated that culturally tailored Community Health Worker-supported education improved engagement in breast cancer screening. Screening rates improved from 32.35% to 45.61%, a 13.26 percentage-point increase among 34 women who were due for screening in 2024. The intervention also improved access to mammography services for uninsured and underinsured women through targeted outreach, navigation assistance, and connections to community-based screening programs. Discussion: Earlier detection through screening may reduce downstream healthcare utilization and costs, supporting sustainable prevention-focused care models. Ongoing community-based, CHW-supported, culturally aligned education is essential to maintaining trust and engagement among underserved populations. Integration of preventive screening prompts into chronic care visits and prioritizing Releases of Information at intake may further improve the accuracy of screening documentation and UDS reporting.

Increasing Breast Cancer Screening in Pacific Islander Women

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