Skip to main content

Advertisement

SpringerLink
Log in

Inadequate Follow-up of Abnormal Screening Mammograms: Findings From the Race Differences in Screening Mammography Process Study (United States)

  • Published:
Cancer Causes & Control Aims and scope Submit manuscript

Abstract

Objective

Despite relatively high mammography screening rates, there are reports of inadequate follow-up of abnormal results. Our objective was to identify factors associated with inadequate follow-up, and specifically, to determine if this outcome differed by race/ethnicity.

Methods

We studied 176 subjects with abnormal or inconclusive mammograms identified from a prospective cohort study of African-American (n = 635) and White (n = 816) women who underwent screening in five hospital-based facilities in Connecticut, October 1996 through January 1998. Using multivariate logistic regression, we identified independent predictors of inadequate follow-up of an abnormal mammogram.

Results

Over 28% of women requiring immediate or short-term follow-up did not receive this care within three months of the recommended return date. African-American race/ethnicity, pain during the mammogram, and lack of a usual provider were significant independent predictors of inadequate follow-up. Although many factors were examined, the observed race difference was unexplained.

Conclusions

While inadequate follow-up of abnormal exams undermines the potential benefits of mammography screening for all women, the observed race difference in this study may have implications for the persistent race difference in breast cancer stage at diagnosis and survival. More research is needed to identify factors that contribute to poor follow-up among African-American women.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. A Jemal T Murray E Ward et al. (2005) ArticleTitleCancer statistics, 2005 CA Cancer J Clin 55 10–30 Occurrence Handle15661684

    PubMed  Google Scholar 

  2. PC Gotzsche O Olsen (2000) ArticleTitleIs screening for breast cancer with mammography justifiable? Lancet 355 129–134 Occurrence Handle10.1016/S0140-6736(99)06065-1 Occurrence Handle10675181

    Article  PubMed  Google Scholar 

  3. O Olsen PC Gotzsche (2001) ArticleTitleCochrane review on screening for breast cancer with mammography Lancet 358 1340–1342 Occurrence Handle10.1016/S0140-6736(01)06449-2 Occurrence Handle11684218

    Article  PubMed  Google Scholar 

  4. JS Michaelson S Satija D Kopans et al. (2003) ArticleTitleGauging the impact of breast carcinoma screening in terms of tumor size and death rate Cancer 98 2114–2124 Occurrence Handle10.1002/cncr.11766 Occurrence Handle14601080

    Article  PubMed  Google Scholar 

  5. RA Smith V Cokkinides HJ Eyre (2004) ArticleTitleAmerican cancer society guidelines for the early detection of cancer, 2004 CA Cancer J Clin 54 41–52 Occurrence Handle14974763

    PubMed  Google Scholar 

  6. U.S. Preventive Services Task Force (2002) Screening for Breast Cancer: Recommendations and Rationale. Rockville, MD: Agency for Healthcare Research and Quality. Available at: http://www.ahrq.gov/clinic/3rduspstf/breastcancer/brcanrr.htm Accessed March 8, 2004

  7. National Cancer Institute (2002) NCI Statement on Mammography Screening. Available at: http://www.nci.nih.gov/newscenter/mammstatement31jan02, Accessed March 8, 2004

  8. E Ward A Jemal V Cokkinides et al. (2004) ArticleTitleCancer disparities by race/ethnicity and socioeconomic status CA Cancer J Clin 54 78–93 Occurrence Handle15061598

    PubMed  Google Scholar 

  9. B Jones EA Patterson L Calvocoressi (2003) ArticleTitleMammograpahy screening in African-American women: evaluating the research Cancer 97(1 Suppl) 258–272 Occurrence Handle10.1002/cncr.11022

    Article  Google Scholar 

  10. CP Hunter (2000) ArticleTitleEpidemiology, stage at diagnosis, and tumor biology of breast carcinoma in multiracial and multiethnic populations Cancer 88 1193–202 Occurrence Handle10.1002/(SICI)1097-0142(20000301)88:5+<1193::AID-CNCR3>3.0.CO;2-D Occurrence Handle10705354

    Article  PubMed  Google Scholar 

  11. CP Hunter CK Redmond VW Chen et al. (1993) ArticleTitleBreast cancer: factors associated with stage at diagnosis in black and white women. Black/White Cancer Survival Study Group J Natl Cancer Inst 85 1129–1137 Occurrence Handle8320742

    PubMed  Google Scholar 

  12. BA Jones SV Kasl MG Curnen PH Owens R Dubrow (1995) ArticleTitleCan mammography screening explain the race difference in stage at diagnosis of breast cancer? Cancer 75 2103–2113 Occurrence Handle7697601

    PubMed  Google Scholar 

  13. J Jacobellis G Cutter (2002) ArticleTitleMammography screening and differences in stage of disease by race/ethnicity Am J Public Health 92 1144–1150 Occurrence Handle12084699

    PubMed  Google Scholar 

  14. EP McCarthy RB Burns SS Coughlin et al. (1998) ArticleTitleMammography use helps to explain differences in breast cancer stage at diagnosis between older black and white women (see comments) Ann 0Intern Med 128 729–736

    Google Scholar 

  15. PA Webber P Fox X Zhang M Pond (1996) ArticleTitleAn examination of differential follow-up rates in breast cancer screening J Commu Health 21 123–132 Occurrence Handle10.1007/BF01682303

    Article  Google Scholar 

  16. M Schootman J Myers-Geadelmann L Fuortes (2000) ArticleTitleFactors associated with adequacy of diagnostic workup after abormal breast cancer screening results J Am Board Fam Practice 13 94–100

    Google Scholar 

  17. JF Kerner M Yedidia D Padgett et al. (2003) ArticleTitleRealizing the promise of breast cancer screening: clinical follow-up after abnormal screening among Black women Prev Med 37 92–101 Occurrence Handle10.1016/S0091-7435(03)00087-2 Occurrence Handle12855208

    Article  PubMed  Google Scholar 

  18. R Burack M Simon M Stano J George J Coombs (2000) ArticleTitleFollow-up among women with an abnormal mammogram in an HMO: is it complete, timely, and efficient Am J Manag Care 6 1102–1112 Occurrence Handle11184666

    PubMed  Google Scholar 

  19. L Caplan D May L Richardson (2000) ArticleTitleTime to Diagnosis and treatment of breast cancer: results from the national breast and cervical cancer early detection program, 1991-1995 Am J Public Health 90 130–133 Occurrence Handle10630153

    PubMed  Google Scholar 

  20. S Chang K Kerlikowske A Napoles-Springer (1996) ArticleTitleRacial differences in timeliness of follow-up after abnormal screening mammography Cancer Practice 78 1395–1402

    Google Scholar 

  21. B McCarthy M Yood E Boohaker R Ward M Rebner C Johnson (1996) ArticleTitleInadequate follow-up of abnormal mammograms Am J Prev Med 12 282–288 Occurrence Handle8874693

    PubMed  Google Scholar 

  22. KR Yabroff KS Washington A Leader E Neilson J Mandelblatt (2003) ArticleTitleIs the promise of cancer-screening programs being compromised? Quality of follow-up care after abnormal screening results Med Care Res Rev 60 294–331 Occurrence Handle10.1177/1077558703254698 Occurrence Handle12971231

    Article  PubMed  Google Scholar 

  23. U.S. Census Bureau Fact Finder. Available at: http://factfinder.census.gov/servlet/BasicFactsTable?_lang=en&_vt_name=DEC_2000_ PL_U_GCTPL_ST7&_geo_id=04000US09. Accessed February 18, 2005

  24. State of Connecticut Department of Economic and Community Development (1990) Connecticut Population Information. Available at: http://www.ct.gov/ecd/cwp/view.asp?a=1106&q= 250666. Accessed February 18, 2005

  25. BA Jones CS Culler SV Kasl L Calvocoressi (2001) ArticleTitleIs variation in quality of mammographic services race linked? J Health Care Poor Underserved 12 113–126 Occurrence Handle11217224

    PubMed  Google Scholar 

  26. InstitutionalAuthorNameAmerican College of Radiology (1998) Breast imaging reporting and data system (BI-RADS®) EditionNumber3 American College of Radiology Reston, VA

    Google Scholar 

  27. OD Duncan (1961) A socioeconomic index for all occupations. R AJ (Eds) Occupations and Social Status Free Press of Glencoe New York 109–138

    Google Scholar 

  28. GF Stevens (1981) ArticleTitleA revised socioeconomic index of occupational status Soc Sci Res 10 364–395 Occurrence Handle10.1016/0049-089X(81)90011-9

    Article  Google Scholar 

  29. InstitutionalAuthorNameNational Institutes of Health (1998) ArticleTitleClinical guidelines on the identification, evaluation, and treatment of overweight and obesity in adults – The evidence report Obes Res 6 IssueID2 51S–209S

    Google Scholar 

  30. T. Holford (2002) Multivariate Methods in Epidemiology Oxford University Press New York, NY

    Google Scholar 

  31. S Greenland (1989) ArticleTitleModeling and variable selection in epidemiological analysis Am J Epidemiol 79 340–9

    Google Scholar 

  32. DK Blackman EM Bennett DS Miller (1999) ArticleTitleTrends in self-reported use of mammograms (1989–1997) and Papanicolaou tests (1991-1997)–Behavioral Risk Factor Surveillance System MMWR CDC Surveill Summ 48 1–22

    Google Scholar 

  33. R Bastani KR Yabroff RE Myers B Glenn (2004) ArticleTitleInterventions to Improve Follow-Up of Abnormal Findings in Cancer Screening Cancer 101(5 Suppl) 1188–1200 Occurrence Handle10.1002/cncr.20506

    Article  Google Scholar 

  34. J Gregg RH Curry (1994) ArticleTitleExplanatory models for cancer among African-American women at two Atlanta neighborhood health centers: the implications for a cancer screening program Soc Sci Med 39 519–26 Occurrence Handle10.1016/0277-9536(94)90094-9 Occurrence Handle7973851

    Article  PubMed  Google Scholar 

  35. TC Davis MV Williams E Marin RM Parker J Glass (2002) ArticleTitleHealth literacy and cancer communication CA Cancer J Clin 52 134–149 Occurrence Handle12018928

    PubMed  Google Scholar 

  36. VW Chen P Correa RJ Kurman et al. (1994) ArticleTitleHistological characteristics of breast carcinoma in blacks and whites Cancer Epidemiol Biomarkers Prev 3 127–135 Occurrence Handle7519506

    PubMed  Google Scholar 

  37. JW Eley HA Hill VW Chen et al. (1994) ArticleTitleRacial differences in␣survival from breast cancer. Results of the National Cancer␣Institute Black/White Cancer Survival Study JAMA 272 947–54 Occurrence Handle10.1001/jama.272.12.947 Occurrence Handle8084062

    Article  PubMed  Google Scholar 

  38. RM Elledge GM Clark GC Chamness CK Osborne (1994) ArticleTitleTumor biologic factors and breast cancer prognosis among white, Hispanic, and black women in the United States J Natl Cancer Inst 86 705–712 Occurrence Handle7908990

    PubMed  Google Scholar 

  39. B Jones SV Kasl CL Howe et al. (2004) ArticleTitleAfrican-American/white differences in breast cancer tumors: p53 alterations and other tumor characteristics Cancer 101 1293–1301 Occurrence Handle10.1002/cncr.20500 Occurrence Handle15368321

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Epidemiology and Public Health, Yale University School of Medicine, 60, College Street, P.O. Box 208034, 06510-2084, New Haven, CT, USA

    Beth A. Jones, Amy Dailey, Lisa Calvocoressi, Kam Reams, Stanislav V. Kasl & Helen Hsu

  2. Department of Diagnostic Radiology, Yale University School of Medicine, New Haven, CT, 06520-8034, USA

    Carol Lee

  3. Children’s Oncology Group, Helen Hsu, Arcadia, California, USA

    Helen Hsu

Authors
  1. Beth A. Jones
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Amy Dailey
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Lisa Calvocoressi
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Kam Reams
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Stanislav V. Kasl
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Carol Lee
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Helen Hsu
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Beth A. Jones.

Additional information

★ Work was performed at the Yale University School of Medicine, Department of Epidemiology & Public Health, New Haven, Connecticut, 06520-8034.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Jones, B.A., Dailey, A., Calvocoressi, L. et al. Inadequate Follow-up of Abnormal Screening Mammograms: Findings From the Race Differences in Screening Mammography Process Study (United States). Cancer Causes Control 16, 809–821 (2005). https://doi.org/10.1007/s10552-005-2905-7

Download citation

  • Received:

  • Accepted:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10552-005-2905-7

Keywords

Search

Navigation