Disparities in abnormal mammogram follow‐up time for Asian women compared with non‐Hispanic white women and between Asian ethnic groups

Nguyen, Kim; Pasick, Rena J.; Stewart, Susan L.; Kerlikowske, Karla; Karliner, Leah

doi:10.1002/cncr.30756

Cited by 36 publications

(36 citation statements)

References 40 publications

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“…Characteristics of included studies chronologically ordered by publication date are outlined in Table 1. Studies comprised one randomised controlled trial (RCT), [34] 11 cohort, [16,18,19,21,22,24,25,[35][36][37][38] two cross-sectional, [23,27], two qualitative studies, [39,40] and two mixed method studies (cross-sectional and qualitative, [17] and cohort and qualitative) [26]. All studies were US-based, except one cohort study from the Netherlands [26].…”

Section: Resultsmentioning

confidence: 99%

“…Despite this, several studies report that follow-up of abnormal mammogram results in primary care is suboptimal, with delayed follow-up associated with poorer patient morbidity and mortality outcomes [4,5]. The extent of inadequate follow-up in primary care and factors influencing follow-up has not been well-studied, however, there is evidence to suggest delayed follow-up is due to health system-, PCP-and patient-related barriers [16][17][18][19][20][21][22][23][24][25][26][27].…”

Section: Introductionmentioning

confidence: 99%

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Delayed or failure to follow-up abnormal breast cancer screening mammograms in primary care: a systematic review

et al. 2021

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Background Successful breast cancer screening relies on timely follow-up of abnormal mammograms. Delayed or failure to follow-up abnormal mammograms undermines the potential benefits of screening and is associated with poorer outcomes. However, a comprehensive review of inadequate follow-up of abnormal mammograms in primary care has not previously been reported in the literature. This review could identify modifiable factors that influence follow-up, which if addressed, may lead to improved follow-up and patient outcomes. Methods A systematic literature review to determine the extent of inadequate follow-up of abnormal screening mammograms in primary care and identify factors impacting on follow-up was conducted. Relevant studies published between 1 January, 1990 and 29 October, 2020 were identified by searching MEDLINE®, Embase, CINAHL® and Cochrane Library, including reference and citation checking. Joanna Briggs Institute Critical Appraisal Checklists were used to assess the risk of bias of included studies according to study design. Results Eighteen publications reporting on 17 studies met inclusion criteria; 16 quantitative and two qualitative studies. All studies were conducted in the United States, except one study from the Netherlands. Failure to follow-up abnormal screening mammograms within 3 and at 6 months ranged from 7.2–33% and 27.3–71.6%, respectively. Women of ethnic minority and lower education attainment were more likely to have inadequate follow-up. Factors influencing follow-up included physician-patient miscommunication, information overload created by automated alerts, the absence of adequate retrieval systems to access patient’s results and a lack of coordination of patient records. Logistical barriers to follow-up included inconvenient clinic hours and inconsistent primary care providers. Patient navigation and case management with increased patient education and counselling by physicians was demonstrated to improve follow-up. Conclusions Follow-up of abnormal mammograms in primary care is suboptimal. However, interventions addressing amendable factors that negatively impact on follow-up have the potential to improve follow-up, especially for populations of women at risk of inadequate follow-up.

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Section: Resultsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Delayed or failure to follow-up abnormal breast cancer screening mammograms in primary care: a systematic review

et al. 2021

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“…Delays in resolution of abnormal mammogram results can cause women psychological distress, including anxiety and depression . Multiple studies have found delays to be common, with estimates ranging from 20% to 40% of abnormal results having delayed follow‐up, and have delineated a disparity in which groups experience them: Delays are more prevalent for low socioeconomic status (SES) and minority women than for higher SES and White women …”

Section: Introductionmentioning

confidence: 99%

“…[23][24][25] Multiple studies have found delays to be common, with estimates ranging from 20% to 40% of abnormal results having delayed follow-up, and have delineated a disparity in which groups experience them: Delays are more prevalent for low socioeconomic status (SES) and minority women than for higher SES and White women. 3,5,[26][27][28][29][30][31][32][33] However, examinations of the disparity in follow-up care after an abnormal mammogram frequently emphasize the individual woman, her attitudes, intentions, and follow-up behavior. [34][35][36][37] Two studies have observed that facilities serving vulnerable women have longer follow-up times for abnormal mammogram results.…”

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confidence: 99%

Mammography facilities serving vulnerable women have longer follow‐up times

Karliner

Kaplan

Livaudais‐Toman

et al. 2018

Health Services Research

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Objective To investigate mammography facilities’ follow‐up times, population vulnerability, system‐based processes, and association with cancer stage at diagnosis. Data Sources Prospectively collected from San Francisco Mammography Registry (SFMR) 2005‐2011, California Cancer Registry 2005‐2012, SFMR facility survey 2012. Study Design We examined time to biopsy for 17 750 abnormal mammogram results (BI‐RADS 4/5), categorizing eight facilities as short or long follow‐up based on proportion of mammograms with biopsy at 30 days. We examined facility population vulnerability (race/ethnicity, language, education), and system processes. Among women with a cancer diagnosis, we modeled odds of advanced‐stage (≥IIb) cancer diagnosis by facility follow‐up group. Data Extraction Methods Merged SFMR, Cancer Registry and facility survey data. Principal Findings Facilities (N = 4) with short follow‐up completed biopsies by 30 days for 82% of mammograms compared with 62% for facilities with long follow‐up (N = 4) (P < 0.0001). All facilities serving high proportions of vulnerable women were long follow‐up facilities. The long follow‐up facilities had fewer radiologists, longer biopsy appointment wait times, and less communication directly with women. Having the index abnormal mammogram at a long follow‐up facility was associated with higher adjusted odds of advanced‐stage cancer (OR 1.45; 95% CI 1.10‐1.91). Conclusions Providing mammography facilities serving vulnerable women with appropriate resources may decrease disparities in abnormal mammogram follow‐up and cancer diagnosis stage.

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“…These findings are supported by a body of literature that demonstrates low knowledge about cancer screening among these groups 12,13–15 as well as suboptimal screening uptake 16 and follow-up. 17,18 Although there was no association between beliefs and mammography and Pap testing uptake, low understanding of the harms and benefits of cancer screening could indicate that individuals often make decisions about screening based on an inaccurate understanding of these tests.…”

Section: Discussionmentioning

confidence: 99%