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 was conducted.
The study included 317 women between 33 and 85 years of age who were reported to have abnormal screening mammography during the period from July 1993 to May 1994.

“Median time to final disposition differed significantly (P<0.001) by race, with medians of 12 days (range, 1 to 192) for white women and 19 days (range, 2 to 176) for nonwhite women.
Nonwhite women had significantly longer time (median time, 19 days) from the date of index abnormal screening mammography and first diagnostic test (median time, 15 days for nonwhite women versus 7 days for white women, P<.0001)…The racial difference was similarly significant for each nonwhite subgroup (African American, Latina, and Asian) when compared with white women (P<0.01).”

“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 due to her physician or system of care need to be explored further.”

As possible explanations for the findings, the authors suggested: patient-induced delay related to individual fears and anxieties, provider-related delay, and poorer access to care of nonwhite women.

“A lower rate of invasive testing (i.e., biopsy) among nonwhites in our series is consistent with reports of racial differences in the evaluation of other disorders, namely cardiovascular disease and cerebrovascular disease. These studies have primarily focused on white versus African American populations and have raised questions concerning potential differences in patient preferences, insurance coverage, and discriminatory practices among providers.”