Is the Promise of Cancer-Screening Programs Being Compromised? Quality of Follow-Up Care after Abnormal Screening Results

Yabroff, K. Robin; Washington, Kathleen Shakira; Leader, Amy; Neilson, Elizabeth A.; Mandelblatt, Jeanne S.

doi:10.1177/1077558703254698

Cited by 123 publications

(151 citation statements)

References 92 publications

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“…1 A systematic review of follow-up care after abnormal screening tests for cervical, breast, and colon cancer showed that < 75% of women received timely and appropriate follow-up care. 2 The proportion of women who were followed after abnormal Pap tests varies dramatically across studies, ranging from 7% to 73%. 2,3 Cervical cancer is preventable through early detection and removal of premalignant changes.…”

Section: Introductionmentioning

confidence: 99%

“…2 The proportion of women who were followed after abnormal Pap tests varies dramatically across studies, ranging from 7% to 73%. 2,3 Cervical cancer is preventable through early detection and removal of premalignant changes. There are few data to indicate what the optimal diagnostic and treatment intervals are that might ensure the best chances of survival from cervical cancer detected by screening.…”

Section: Introductionmentioning

confidence: 99%

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Timeliness of Cervical Cancer Diagnosis and Initiation of Treatment in the National Breast and Cervical Cancer Early Detection Program

Benard

Howe²,

Royalty³

et al. 2012

Journal of Women's Health

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Objectives-To examine time intervals from cervical cancer screening to diagnosis and treatment initiation among low-income and uninsured women in the National Breast and Cervical Cancer Early Detection Program (NBCCEDP) during two consecutive time periods.Methods-We analyzed NBCCEDP data for women with abnormal Pap tests (n = 100,167), from which 1,417 invasive cervical cancers were diagnosed. We examined two time intervals for this study: diagnostic interval (time from abnormal Pap test to the date of definitive diagnosis) and treatment initiation interval (time from definitive diagnosis to treatment initiation) for two time periods : 1996-2002 and 2003-2009. We compared median time intervals for diagnostic and treatment initiation using the Kruskal-Wallis test. Adjusted proportions (predicted marginals) were calculated using logistic regression to examine diagnosis and treatment within program benchmarks (≤ 60 days).Results-Median diagnostic intervals decreased overall by 6 days (54 vs. 48 days, p < 0.001). This decrease in the median diagnostic interval was noted for all variables examined. The median treatment initiation intervals remained stable over the two time periods.Conclusions-Women screened by the NBCCEDP receive diagnostic follow-up and initiate treatment within preestablished program guidelines.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Timeliness of Cervical Cancer Diagnosis and Initiation of Treatment in the National Breast and Cervical Cancer Early Detection Program

Benard

Howe²,

Royalty³

et al. 2012

Journal of Women's Health

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“…16 In our study, ultrasound, cytology and physician consultation were provided on site for Kayole and South B sites, which explains the follow-up time of 1 day; however, availability of these services did not statistically influence return of patients.…”

Section: Discussionmentioning

confidence: 99%

“…Non-navigated (n = 38) 23.7 (9) 76.3 (29) Navigation (n = 38) 57.9 (22) 42.1 (16) Overall, factors that were associated with return for followup included navigation (p = 0.003), marital status (p = 0.02) and education status above secondary school (p = 0.007). The rest of the factors were not significant (Table 4).…”

Section: Return Defaultermentioning

confidence: 99%

Effect of a breast navigation programme in a teaching hospital in Africa

Riogi

Wasike²,

Saidi

2017

S. Afr. j. oncol.

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Background: Breast cancer screening programmes have been developed in few developing countries to aid curb the increasing burden. However, breast cancer is still being detected in late stage, attributed to barriers in health care. Patient navigation programmes have been implemented in developed countries to help patients overcome these barriers, and they have been associated with early detection and timely diagnosis. Despite the consistent positive effects of breast navigation programmes, there are no studies conducted to show its effect in Africa where the needs are enormous. Aim: To evaluate the effect of patient navigation programme on patient return after an abnormal clinical breast cancer screening examination finding at Aga Khan University Hospital, Nairobi(AKUH-N). Setting: Women presenting for breast screening. Methods: This was a before-and-after study conducted on 76 patients before and after the implementation of the navigation programme. They were followed up for 30 days. Measures included proportion of patient return and time to return. Results: The proportion of return of patients in the navigated and non-navigated group was 57.9% and 23.7%, respectively (odds ratio [OR]: 4.43 [95% confidence interval, CI: 1.54– 12.78]; p = 0.0026).The proportion of timely return in the navigated group was 90.1% and 77.8% for the non-navigated group (OR: 2.85 [95% CI: 0.34–24.30], p = 0.34). The mean time to return in the non-navigated and navigated group was 7.33 days and 8.33 days, respectively (p = 0.67). Conclusion: There was an increase in the proportion of patients who returned for follow-up following abnormal clinical breast examination finding after implementation of the breast navigation programme at AKUH-N.

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“…Previous studies showed less than 25% of these vulnerable women received adequate follow-up care after an abnormal cancer screening test. 8,9 In addition, the prevalence of depression is higher in vulnerable populations, [10][11][12][13][14][15][16] and twofold higher in women than men. National annual prevalence estimates for women range between 4 -14%.…”

mentioning

confidence: 99%

Depression and Anxiety Diagnoses Are Not Associated with Delayed Resolution of Abnormal Mammograms and Pap Tests Among Vulnerable Women

et al. 2011

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BACKGROUND: Delays in care after abnormal cancer screening contribute to disparities in cancer outcomes. Women with psychiatric disorders are less likely to receive cancer screening and may also have delays in diagnostic resolution after an abnormal screening test. OBJECTIVE: To determine if depression and anxiety are associated with delays in resolution after abnormal mammograms and Pap tests in a vulnerable population of urban women. DESIGN: We conducted retrospective chart reviews of electronic medical records to identify women who had a diagnosis of depression or anxiety in the year prior to the abnormal mammogram or Pap test. We used timeto-event analysis to analyze the outcome of time to resolution after abnormal cancer screening, and Cox proportional hazards regression modeling to control for confounding. PARTICIPANTS: Women receiving care in six Bostonarea community health centers 2004-2005: 523 with abnormal mammograms, 474 with abnormal Pap tests. RESULTS: Of the women with abnormal mammogram and pap tests, 19% and 16%, respectively, had comorbid depression. There was no difference in time to diagnostic resolution between depressed and not-depressed women for those with abnormal mammograms (aHR=0.9, 95 CI 0.7,1.1) or Pap tests (aHR=0.9, 95 CI 0.7,1.3). CONCLUSIONS: An active diagnosis of depression and/ or anxiety in the year prior to an abnormal mammogram or Pap test was not associated with a prolonged time to diagnostic resolution. Our findings imply that documented mood disorders do not identify an additional barrier to resolution after abnormal cancer screening in a vulnerable population of women.KEY WORDS: depression; cancer screening; women's health; minority populations.

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Is the Promise of Cancer-Screening Programs Being Compromised? Quality of Follow-Up Care after Abnormal Screening Results

Cited by 123 publications

References 92 publications

Timeliness of Cervical Cancer Diagnosis and Initiation of Treatment in the National Breast and Cervical Cancer Early Detection Program

Timeliness of Cervical Cancer Diagnosis and Initiation of Treatment in the National Breast and Cervical Cancer Early Detection Program

Effect of a breast navigation programme in a teaching hospital in Africa

Depression and Anxiety Diagnoses Are Not Associated with Delayed Resolution of Abnormal Mammograms and Pap Tests Among Vulnerable Women

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