Cancer
1996 Oct 1;78(7):1395-402
Racial differences in timeliness of follow-up after abnormal screening mammography.
Chang SW, Kerlikowske K, Napoles-Springer A, Posner SF, Sickles EA, Perez-Stable
EJ.
Medical Effectiveness Research Center for Diverse Populations, University
of California, San Francisco 94143-0856, USA.
BACKGROUND: To determine whether patient race was associated
with timeliness of follow-up after abnormal screening mammography, a retrospective
record review of diagnostic tests for women with abnormal screening mammography
from a Northern California mobile van program was conducted.
METHODS: The study included 317 women between the ages
of 33 and 85 who were reported to have abnormal screening mammography
between July 1993 and May 1994. Measurements included patient demographics,
screening mammography interpretation, follow-up diagnostic tests, and
dates of diagnostic evaluation.
RESULTS: Women with abnormal screening mammography underwent
a wide variety of diagnostic evaluations. Nonwhite women had significantly
longer time (median time, 19 days) from date of index abnormal screening
mammography to final disposition compared with white women (median time,
12 days). This racial difference was primarily due to the longer interval
between index abnormal screening mammography and first diagnostic test
(median time, 15 days for nonwhite women versus 7 days for white women,
P < 0.001). The difference persisted when adjusting for patient age,
family history of breast cancer, report of palpable mass, and income.
The racial difference was similarly significant for each nonwhite subgroup
(African American, Latina, and Asian) when compared with white women (P
< 0.01).
CONCLUSIONS: Reasons for less timely follow-up of abnormal
mammography among nonwhite women need to be identified. Delays that may
be instigated by the patient or be due to her physician or system of care
need to be explored further.
PMID: 8839544 [PubMed - indexed for MEDLINE]