Increasing breast and cervical cancer screening in low-income women.

<bold>Objective: </bold>To determine if women would have higher breast and cervical cancer screening rates if lay health advisers recommended screening and offered a convenient screening opportunity.<bold>Design: </bold>Controlled trial.<bold>Setting: </bold>Urban county teaching hospital.<bold>Participants: </bold>Women aged 40 years and over attending appointments in several non-primary-care outpatient clinics.<bold>Interventions: </bold>Lay health advisers assessed the participants' breast and cervical cancer screening status and offered women in the intervention group who were due for screening an appointment with a female nurse practitioner.<bold>Measurements and Main Results: </bold>Screening rates at baseline and at follow-up 1 year after the intervention were determined. At follow-up, the mammography rate was 69% in the intervention group versus 63% in the usual care group (p = .009), and the Pap smear rate was 70% in the intervention group versus 63% in the usual care group (p = .02). In women who were due for screening at baseline, the mammography rate was 60% in the intervention group versus 50% in the usual care group (p = .006), and the Pap smear rate was 63% in the intervention group versus 50% in the usual care group (p = .002). The intervention was effective across age and insurance payer strata, and was particularly effective in Native American women.<bold>Conclusions: </bold>Breast and cervical cancer screening rates were improved in women attending non-primary-care outpatient clinics by using lay health advisers and a nurse practitioner to perform screening. The effect was strongest in women in greatest need of screening. [ABSTRACT FROM AUTHOR]