TABLE 1.

Breast Cancer Screening Rates Among 32 Community Health Centers, 2018‐2020

	No. of Clinics	2018 (n = 142,207) a	2019 (n = 142,003) a	2020 (n = 150,630) a	2019 vs 2018			2020 vs 2019
		BCSR, % b			SRR	95% CI c		SRR	95% CI c
Total	32	45.8	53.9	49.6	1.18	1.17	1.18	0.92	0.92	0.93
Urban/rural
Rural	4	23.0	36.5	35.1	1.59	1.53	1.65	0.96	0.93	0.99
Urban	28	48.3	55.4	51.3	1.15	1.14	1.15	0.93	0.92	0.93
Region d
Midwest	8	38.5	48.6	43.7	1.26	1.24	1.29	0.90	0.88	0.92
Northeast	6	65.5	64.4	56.4	0.98	0.97	0.99	0.88	0.87	0.89
South	11	33.4	45.8	45.4	1.37	1.35	1.39	0.99	0.98	1.00
West	7	51.5	59.6	53.8	1.16	1.14	1.18	0.90	0.89	0.91
% Uninsured e
Low (<13.3%)	12	59.4	62.4	53.1	1.05	1.04	1.06	0.85	0.84	0.86
Medium (13.3%‐26.2%)	9	37.3	52.2	50.2	1.40	1.38	1.42	0.96	0.95	0.97
High (≥26.3%)	11	37.0	43.4	42.0	1.17	1.15	1.20	0.97	0.95	0.98
% Hispanic e
Low (<10%)	10	31.0	45.1	41.5	1.46	1.42	1.49	0.92	0.90	0.94
Medium (10%‐32%)	11	49.1	52.2	47.7	1.06	1.05	1.08	0.91	0.90	0.92
High (≥33%)	11	48.6	57.9	54.1	1.19	1.18	1.20	0.93	0.92	0.94
% Black e
Low (<22%)	10	40.2	52.5	49.9	1.31	1.29	1.33	0.95	0.94	0.97
Medium (22%‐50%)	11	46.8	53.9	49.7	1.15	1.14	1.16	0.92	0.91	0.93
High (≥51%)	11	49.9	55.3	48.9	1.11	1.09	1.12	0.88	0.87	0.90

Abbreviations: BCSR, breast cancer screening rate; CI, confidence interval; SE, standard error; SRR, screening rate ratio.

^a The n value is the number of women in the denominator (defined as women aged 50‐74 years who had a medical visit within the past 12 months).

^b BCSRs were defined according to the Centers for Medicare and Medicaid Services Measurement Identification Number 125 (CMS‐125) measure as the percentage of women aged 50 to 74 years who had a medical visit within the past 12 months and received a screening mammogram within the last 27 months. The 2018, 2019, and 2020 BCSRs were as of June 2018, July 2019, and July 2020, respectively.

^c SEs were determined with a delta method–derived formula:

$\text{SE}\log \left(\text{SRR}\right)={\left[\left(\mathrm{p}1\right)/\left(\mathrm{p}1\times \mathrm{n}1\right)+\left(\mathrm{p}2\right)/\left(\mathrm{p}2\times \mathrm{n}2\right)\right]}^{0.5}$

$\text{CI}=\exp \left[\ln \left(\text{SRR}\right)+/‐1.96\times \text{SE}\right]$

where p is the proportion of women screened and n is the number of women eligible (those aged 50‐74 years who had a medical visit in the past 12 months) for comparison years. For example, for the 2020‐2019 SRR, p1 was the proportion screened in 2020, n1 was the number of eligible women in 2020, p2 was the proportion screened in 2019, and n2 was the number of eligible women in 2019.

^d Based on US Census regions.

^e Low, medium, and high were defined according to tertile ranks with the ranges presented in the table. For example, low for the percentage uninsured included clinics with the lowest proportion of uninsured patients. There were 12 clinics with a low proportion of uninsured because of a tie in the proportion uninsured.