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The 130th Annual Meeting of APHA |
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The 130th Annual Meeting of APHA |
Patricia M Stauber, MPH1, Sharon J Wayne, MSPH1, Robert D Rosenberg, MD2, and William C. Hunt, MS1. (1) Epidemiology and Cancer Control, University of New Mexico, Health Sciences Center, Albuquerque, NM 87131-5306, 505/272-6866, pstauber@salud.unm.edu, (2) Department of Radiology, University of New Mexico, Health Sciences Center, Albuquerque, NM 87131
Much work has been done in recent years to inform women about the benefits of mammography screening. The majority of women age 50 and older have had at least one mammogram. However, screening mammography is not useful if the abnormal cases are not completed. It is difficult to estimate how often this occurs in communities because patients may go to many locations for follow-up care. The New Mexico Mammography Project (NMMP) collects statewide mammography data as well as data on breast cancer incidence and benign biopsies. Linkage of these data sources should provide good estimates of completeness of follow-up in a community. Methods: The study population included women age 40 and over who had at least one asymptomatic screening mammogram in any year from 1994-1999 (n=283,308). We looked at the results of screening exams for any indication that follow-up was needed, i.e. Bi-RADS codes 0,4,5 or 3 with a recommendation for additional follow-up. We looked for the next event within 9 months for those with an initial assessment of 0 or within 6 months for those with a recommendation for biopsy (Bi-RADS 4 or 5). We measured time to follow-up for all women with either an initial or subsequent recommendation for biopsy. Follow-up was considered to be adequate if the patient received a biopsy or a negative assessment within 31 days and inadequate otherwise. We tested the following risk factors for an association with inadequate follow-up: age, ethnicity, previous mammogram and family history of breast cancer. Results: Overall about 7% of women had no follow-up within 9 months of an initial incomplete assessment and 6% had no follow-up within 6 months of a biopsy recommendation. The average time to follow-up after an incomplete evaluation was 14.5 days while the mean time to the next event for a biopsy recommendation was 32.8 days. Forty-four percent of women had an abnormal mammogram finding resolved within 31 days. Having had a previous mammogram and non-Hispanic white ethnicity were associated with adequate follow-up. There was no association with age or family history of breast cancer. Conclusions: Follow-up of an incomplete mammographic assessment generally occurs within about 2 weeks, follow-up which may need surgical intervention averages over 30 days, with a majority of women receiving inadequate follow-up by our criterion. The reasons for this need further study but there is a suggestion that ethnic differences and access to health care may play a role.
Learning Objectives:
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.
Handout (.pdf format, 46.9 kb)