St. John’s Hospitals – Women under 40 Breast Cancer Early Detection Program

Oxnard, CA
November 2017

Overview
The Women under 40 Breast Cancer Early Detection Program at St. John’s Hospitals provides medically necessary diagnostic mammography and ultrasound for underserved, uninsured and disenfranchised women under the age of 40 who do not have the ability to pay the out-of-pocket expense. The impetus for the creation of the program arose from the personal stories of young women in the community who suffered from having a suspicious breast exam but were unable to pay for the next diagnostic step to confirm the presence, or absence, of cancer. We began our program in 2000. In the intervening years, the demand for our program resources has grown exponentially, underscoring the tremendous need for this service in our community. This program partners with the community’s low-income clinics to identify women in need. It also partners with Dignity Health St. John’s Regional Medical Center radiology department for a steeply discounted fee for diagnostic mammograms/ultrasounds, thus allowing the program to serve more women.

Impact
The state of California has one of the highest incidences of breast cancer in the country, and Ventura County has one of the higher rates of breast cancer in the state. Although breast cancer is often thought of as an older woman’s disease, young women can and do get breast cancer. More than 75 percent of the women we serve have Hispanic surnames, and the majority are solely Spanish-speaking. In 2016, we provided 162 diagnostic mammograms/ultrasounds to women under the age of 40 – at no cost to them. Of these, 14 women (or 8.6 percent) had a suspicious finding requiring a biopsy. The women requiring further care were referred, and follow-up was provided to ensure access to appropriate breast care.

Lessons Learned
The Under 40 Program may have saved women’s lives. Uninsured women with breast cancer have a 30 to 50 percent higher risk of dying than women with private health insurance, mostly because of a delayed diagnosis, fear, no knowledge of resources and insufficient funds for care. More than twice as many Latina/Hispanic women in Ventura County are uninsured, and they are two to three times more likely to have cancer diagnosed at a later stage, making it less curable. We do not turn away any woman in need, regardless of the hospital or clinic where she receives her primary care.

Future Goals
Women in the Under 40 Program have access to all the educational services at the Cancer Center with a focus on understanding screening and diagnostic tests for benign breast disease, breast cancer and treatment options. We would like to expand our educational offerings to include a greater emphasis on lifestyle change for breast cancer prevention, including diet, weight control, and physical activity, ultimately linking young women with the Public Health Department’s programs that include classes on weight control, cooking, and exercise offered in the neighborhoods where most of our participants live.

Contact: Deborah Klein
Vice President, Philanthropy
Telephone: 805-988-2635
Email: deborah.klein@dignityhealth.org