Realizing the promise of breast cancer screening: Clinical follow-up after abnormal screening among Black women

Jon F. Kerner, Michael Yedidia, Deborah Padgett, Barbara Muth, Kathleen Shakira Washington, Mariella Tefft, K. Robin Yabroff, Erini Makariou, Harold Freeman, Jeanne S. Mandelblatt

Research output: Contribution to journalArticle

Abstract

Background. Delayed or incomplete follow-up after abnormal screening results may compromise the effectiveness of breast cancer screening programs, particularly in medically underserved and minority populations. This study examined the role of socioeconomic status, breast cancer risk factors, health care system barriers, and patient cognitive-attitudinal factors in the timing of diagnostic resolution after abnormal breast cancer screening exams among Black women receiving breast cancer screening at three New York city clinics. Methods. We identified 184 Black women as having an abnormal mammogram or clinical breast exam requiring immediate follow-up and they were interviewed and their medical records examined. Bivariate and multivariate logistic regression analyses were used to assess the association between patient and health care system factors and diagnostic resolution within 3 months of the abnormal finding. Results. Within 3 months, 39% of women were without diagnostic resolution and 28% within 6 months. Neither socioeconomic status nor system barriers were associated with timely diagnostic resolution. Timely resolution was associated with mammogram severity, patients asking questions (OR, 2.73; 95% CI, 1.25-5.96), or receiving next step information (OR, 2.6; 95% CI, 1.08-6.21) at the initial mammogram. Women with prior breast abnormalities were less likely to complete timely diagnostic resolution (OR, 0.42; 95% CI, 0.20-0.85), as were women with higher levels of cancer anxiety (OR, 0.50; 95% CI, 0.27-0.92). Conclusions. Interventions that address a woman's prior experience with abnormal findings and improve patient/provider communication may improve timely and appropriate follow-up.

Original languageEnglish (US)
Pages (from-to)92-101
Number of pages10
JournalPreventive Medicine
Volume37
Issue number2
DOIs
StatePublished - Aug 1 2003

Keywords

  • Adherence
  • Follow-up studies
  • Mammography
  • Mass screening
  • Social class

ASJC Scopus subject areas

  • Epidemiology
  • Public Health, Environmental and Occupational Health

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    Kerner, J. F., Yedidia, M., Padgett, D., Muth, B., Washington, K. S., Tefft, M., Yabroff, K. R., Makariou, E., Freeman, H., & Mandelblatt, J. S. (2003). Realizing the promise of breast cancer screening: Clinical follow-up after abnormal screening among Black women. Preventive Medicine, 37(2), 92-101. https://doi.org/10.1016/S0091-7435(03)00087-2