The 130th Annual Meeting of APHA

Abstract #47480

Beth A. Jones, PhD, MPH¹, Helen Hsu¹, Nancy Tran, MPH¹, Lisa Calvocoressi², Stanislav V Kasl³, and Carol H. Lee⁴. (1) Epidemiology and Public Health, Yale University School of Medicine, 60 College Street, PO Box 208034, New Haven, CT 06520-8034, 203-785-2890, Beth.Jones@Yale.edu, (2) Department of Epidemiology and Public Health, Yale University School of Medicine, 60 College Street, PO Box 208034, New Haven, CT 06520-8034, (3) Epidemiology & Public Health, Yale University School of Medicine, 60 College Street, PO Box 208034, New Haven, CT 06520-8034, (4) Department of Diagnostic Radiology, Yale University School of Medicine, 333 Cedar Street, New Haven, CT 06520-8034

The purpose of this study was to identify factors that are associated with inadequate follow-up after an abnormal screening mammogram. From a larger prospective study of 1,451 (40% African American; 60% White) women, ages 40 -79, who participated in a 45 minute baseline telephone interview shortly after receiving an index mammogram from one of 5 major mammography centers across Connecticut, 194 women were determined as having abnormal results on the index exam. Mammography reports were used to make this determination for the majority of subjects; for women who did not return consent forms allowing access to medical records, we relied on interview data alone (resulting in 56 abnormal exams). Abnormal mammograms were defined as those that were consistent with a BIRADS (Breast Imaging Reporting and Data System, 3rd Ed) classification that calls for further diagnostic testing and/or treatment. Adequacy of follow-up was defined as receipt of such testing/treatment within 3 months of specified time for follow-up. Inadequate follow-up was significantly more common for African American women (Odds ratio [OR]=2.61, 95% confidence interval [CI] 1.35 – 5.07). Other factors that were significantly (p < .05) related to inadequate follow up included: not living as married, family income less than $30,000/year, poor continuity of medical care, and experiencing pain during the index mammogram. Race and pain remained significant predictors in multivariate models. With only 71% of all women receiving adequate follow-up for abnormal screening exams, it is clear that the full benefit of mammography screening is not being realized in practice.

Learning Objectives:

• Recognize role of adequate follow-up of abnormal exams in efficacy of screening mammography programs
• Identify factors that are associated with inadequate follow-up following screening mammograms
• Recognize that race/ethnic differences in receipt of adequate follow-up from screening mammograms likely contributes to persistent race/ethnic differences in survival

Keywords: African American, Breast Cancer Screening

Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.