Racial Differences in Follow-Up of Abnormal Mammography Findings Among Economically Disadvantaged Women

被引:45
作者
Adams, Swann A. [1 ,2 ]
Smith, Emily R. [2 ]
Hardin, James
Prabhu-Das, Irene [3 ]
Fulton, Jeanette [4 ]
Hebert, James R. [2 ]
机构
[1] Univ S Carolina, Canc Prevent & Control Program, Arnold Sch Publ Hlth, Dept Epidemiol & Biostat, Columbia, SC 29208 USA
[2] S Carolina Statewide Canc Prevent & Control Progr, Columbia, SC USA
[3] NCI, Div Canc Control & Populat Sci, Bethesda, MD 20892 USA
[4] S Carolina Comprehens Breast Ctr, Columbia, SC USA
关键词
mammography; health status disparities; African Americans; medically uninsured; breast neoplasms; BREAST-CANCER SURVIVAL; AFRICAN-AMERICAN; SCREENING MAMMOGRAPHY; UNITED-STATES; WHITE WOMEN; DIAGNOSIS; RACE; CARE; CARCINOMA; DELAY;
D O I
10.1002/cncr.24633
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
BACKGROUND: In the United States, and particularly in South Carolina, African-American women suffer disproportionately higher mortality rates from breast cancer than European-American women. The timeliness of patient adherence to the follow-up of mammographic abnormalities may influence prognosis and survival. The objective of the current investigation was to examine racial differences in the completion and completion time of a diagnostic workup after the finding of a suspicious breast abnormality. METHODS: Study participants of the Best Chance Network, a statewide service program that provides free mammography screening to economically disadvantaged and medically underserved women, were included in the study. Racial differences in tumor characteristics and adherence to recommended workup were tested using chi-square tests and t tests. Logistic and Cox regression modeling was used to assess the relation between workup completion and other factors among African-American women and European-American women. RESULTS: Completion of the workup was associated with the number of previous procedures and income, and no significant differences were noted by race. The amount of time to completion of the workup was influenced by previous procedures, income, and race. After accounting for completion time, African-American women were 12% less likely than European-American women to complete the recommended workup (hazard ratio, 0.88; P = .01). CONCLUSIONS: The results from this study established a racial disparity in the time to completion of a diagnostic workup among Best Chance Network participants. These findings highlight the importance of understanding the factors associated with delays in and adherence to completing the recommended workup when breast abnormalities are detected in mammograms. Cancer 2009;115:5788-97. (C) 2009 American Cancer Society.
引用
收藏
页码:5788 / 5797
页数:10
相关论文
共 55 条
[1]  
Adams Swann Arp, 2006, J S C Med Assoc, V102, P231
[2]   Mammograms and healthcare access among US Hispanic and non-Hispanic women 40 years and older [J].
Aldridge, ML ;
Daniels, JL ;
Jukic, AM .
FAMILY & COMMUNITY HEALTH, 2006, 29 (02) :80-88
[3]  
[Anonymous], 1998, AJCC CANC STAGING MA
[4]  
[Anonymous], 2003, BREAST IM REP DAT SY
[5]   Reasons for delay in breast cancer diagnosis [J].
Caplan, LS ;
Helzlsouer, KJ ;
Shapiro, S ;
Wesley, MN ;
Edwards, BK .
PREVENTIVE MEDICINE, 1996, 25 (02) :218-224
[6]   Breast cancer and electromagnetic fields - A review [J].
Caplan, LS ;
Schoenfeld, ER ;
O'Leary, ES ;
Leske, MC .
ANNALS OF EPIDEMIOLOGY, 2000, 10 (01) :31-44
[7]   Time to diagnosis and treatment of breast cancer: Results from the National Breast and Cervical Cancer Early Detection Program, 1991-1995 [J].
Caplan, LS ;
May, DS ;
Richardson, LC .
AMERICAN JOURNAL OF PUBLIC HEALTH, 2000, 90 (01) :130-134
[8]   SYSTEM DELAY IN BREAST-CANCER IN WHITES AND BLACKS [J].
CAPLAN, LS ;
HELZLSOUER, KJ ;
SHAPIRO, S ;
FREEDMAN, LS ;
COATES, RJ ;
EDWARDS, BK .
AMERICAN JOURNAL OF EPIDEMIOLOGY, 1995, 142 (08) :804-812
[9]   RATE OF COMPLIANCE WITH RECOMMENDATIONS FOR ADDITIONAL MAMMOGRAPHIC VIEWS AND BIOPSIES [J].
CARDENOSA, G ;
EKLUND, GW .
RADIOLOGY, 1991, 181 (02) :359-361
[10]  
Chang S, 1997, CANCER EPIDEM BIOMAR, V6, P881