An examination of differential follow-up rates in breast cancer screening

Webber, Pamela; Fox, Patrick J.; Zhang, Xiulan; Pond, Mikki

doi:10.1007/bf01682303

Cited by 27 publications

(24 citation statements)

References 25 publications

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“…Data from the California State BCCCP, which thus far includes 22,176 women who underwent screening mammography from October, 1991, to June, 1994, indicates that there are differential rates of follow-up for women after abnormal mammography [20]. Overall, 5.4% of screening mammographic examinations were interpreted as abnormal, which is similar to other studies which report 5% to 8% abnormal [16,[21][22][23][24][25], but lower than the national average [1].…”

Section: California State Breast and Cervical Cancer Control Projectsupporting

confidence: 78%

“…The proportion of women receiving timely followup after abnormal mammography (first diagnostic test within 8 to 12 weeks) ranges from 69% to 99% [1,20,[27][28][29][30]. Women aged 65 and older, those of lower socioeconomic status, and those who are instructed to have repeat evaluations in four to six months have the lowest rate of timely follow-up.…”

Section: Discussionmentioning

confidence: 99%

“…However, a slightly lower proportion of Asian or Pacific Islanders and Native American women had timely evaluation of abnormal mammography (69% and 62%, respectively) compared to white, African American, and Hispanic women (73%, 77%, and 74%, respectively). Geographic location had little influence on follow-up after abnormal mammography, with similar proportions of women from urban areas having timely follow-up compared to women from rural areas (72% versus 79%) [20].…”

Section: California State Breast and Cervical Cancer Control Projectmentioning

confidence: 98%

“…b National Cancer Institute National Survey of Mammography Facilities, data from 50 sites; median based on N=1551 abnormal examinations (unpublished data). c California State Breast and Cervical Cancer Control Project, data from 86 clinic sites [20]. d Henry Ford Health System, data from five mammography sites [27].…”

Section: Introductionmentioning

confidence: 99%

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Timeliness of follow-up after abnormal screening mammography

Kerlikowske

1996

Breast Cancer Res Tr

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Little information has been published concerning the timeliness of follow-up after abnormal mammography. This article presents data on follow-up after abnormal mammography, including differences in follow-up by age, race, mammographic interpretation, and type of tracking system. From unpublished data, the rate of timely follow-up 8 to 12 weeks after index abnormal mammography ranges from 69% to 99%. Women aged 65 and older, those of lower socioeconomic status, and those who are instructed to have repeat evaluations in four to six months have the highest proportion of untimely follow-up. With use of computer-based tracking systems, timely follow-up ranges from 89% to 99%. Computer-based tracking systems should be encouraged to promote timely follow-up of abnormal mammography. Further research is needed to better delineate those at risk for untimely follow-up after abnormal mammography, causes of untimely follow-up, the impact of untimely follow-up on breast cancer stage and mortality, and interventions that maximize timely follow-up.

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Section: California State Breast and Cervical Cancer Control Projectsupporting

confidence: 78%

Section: Discussionmentioning

confidence: 99%

Section: California State Breast and Cervical Cancer Control Projectmentioning

confidence: 98%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Timeliness of follow-up after abnormal screening mammography

Kerlikowske

1996

Breast Cancer Res Tr

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“…Ninety-six percent of women with abnormal findings on breast screening received diagnostic procedures, which indicates that even women of lower socioeconomic status can receive these services when indicated. This percentage of women receiving diagnostic workup is much higher than that reported by a study using BCCEDP data in California 16 and is necessary to maximize screening benefits.…”

Section: Discussionmentioning

confidence: 69%

Factors Associated With Adequacy of Diagnostic Workup After Abnormal Breast Cancer Screening Results

Schootman

Myers-Geadelmann

Fuortes

2000

The Journal of the American Board of Family Medicine

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Background: Women with certain characteristics, such as those residing in rural areas, are less likely screened for breast cancer. To enhance detection of early breast cancer, it is imperative that all women who have abnormal screening results receive appropriate diagnostic procedures. This study reports differences in receipt of diagnostic services following abnormal screening results.Methods: Screening and diagnostic data were collected as part of a breast and cervical cancer early detection program aimed at reaching women of lower socioeconomic status. Women with completed diagnostic information after having abnormal screening results were included. We based adequacy of diagnostic services on guidelines from the Society for Surgical Oncology, The Commission on Cancer of the American College of Surgeons, and the Centers for Disease Control and Prevention. Several factors were assessed for their association with adequacy of diagnostic follow-up: income, age, race, education, health insurance status, rural-urban residence, reported breast lump, family history of breast cancer, and clinical beast examination or mammogram results.Results: Overall, 14.1% of the 351 abnormal findings were considered inadequately followed up based on the algorithm used. Eighty percent involved an abnormal finding on a clinical breast examination regardless of the mammogram results. Rural women, those with abnormal clinical breast examination findings but normal or equivocal findings on mammograms, and those who self-discovered a mass were less likely to receive adequate follow-up than were their counterparts in multivariate analysis. Rural women were less likely to receive a biopsy or fine-needle aspiration, although it was indicated. One facility accounted for most of the inadequate follow-up screenings among urban women.Conclusions: Women who have specific demographic and clinical characteristics were less likely to have received adequate diagnostic services. Breast cancers could have been missed initially as a result of inappropriate follow-up. Further investigation of the clinical scenarios using chart reviews is warranted. (J Am Board Fam Pract 2000;13:94-100.)

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Improving follow-up to abnormal breast cancer screening in an urban population

Battaglia

Roloff²,

Posner

et al. 2007

Cancer

222

101

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Delays in follow-up after cancer screening contribute to racial/ethnic disparities in cancer outcomes. We evaluated a patient navigator intervention among innercity women with breast abnormalities. A full-time patient navigator supported patients using the care management model. Female patients 18 years and above, referred to an urban, hospital-based, diagnostic breast health practice from January to June 2000 (preintervention) and November 2001 to February 2003, were studied. Timely follow-up was defined as arrival to diagnostic evaluation within 120 days from the date the original appointment was scheduled. Data were collected via computerized registration, medical records, and patient interview. Bivariate and multivariate logistic regression analyses were conducted, comparing preintervention and intervention groups, with propensity score analysis and time trend analysis to address the limitations of the pre-post design. 314 patients were scheduled preintervention; 1018, during the intervention. Overall, mean age was 44 years; 40% black, 36% non-Hispanic white, 14% Hispanic, 4% Asian, 5% other; 15% required an interpreter; 68% had no or only public insurance. Forty-four percent of referrals originated from a community health center, 34% from a hospital-based practice. During the intervention, 78% had timely follow-up versus 64% preintervention (P < .0001). In adjusted analyses, women in the intervention group had 39% greater odds of having timely follow-up (95% CI, 1.01-1.9). Timely follow-up in the adjusted model was associated with older age (P ¼ .0003), having private insurance (P ¼ .006), having an abnormal mammogram (P ¼ .0001), and being referred from a hospital-based practice, as compared to a community health center (P ¼ .003). Our data suggest a benefit of patient navigators in reducing delay in breast cancer care for poor and minority populations.

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An examination of differential follow-up rates in breast cancer screening

Cited by 27 publications

References 25 publications

Timeliness of follow-up after abnormal screening mammography

Timeliness of follow-up after abnormal screening mammography

Factors Associated With Adequacy of Diagnostic Workup After Abnormal Breast Cancer Screening Results

Improving follow-up to abnormal breast cancer screening in an urban population

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