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Am J Prev Med. 2016 Oct;51(4):507-12. doi: 10.1016/j.amepre.2016.03.017. Epub 2016 Apr 28.

Follow-Up of Abnormal Breast and Colorectal Cancer Screening by Race/Ethnicity.

Author information

1
Department of Medicine, Massachusetts General Hospital, Boston, Massachusetts. Electronic address: amccarthy8@partners.org.
2
Department of Health Policy and Management, Harvard T.H. Chan School of Public Health, Boston, Massachusetts.
3
Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, Washington.
4
Department of Biostatistics, Fred Hutchinson Cancer Research Center, Seattle, Washington.
5
Division of Epidemiology, Fred Hutchinson Cancer Research Center, Seattle, Washington; Institute for Health Research, Kaiser Permanente Colorado, Denver, Colorado.
6
Group Health Research Institute, Seattle, Washington.
7
Department of Research and Evaluation, Kaiser Permanente Southern California, Pasadena, California.
8
Health Systems and Interventions Research Branch, National Cancer Institute, Bethesda, Maryland.
9
Department of Radiology, University of Pennsylvania, Philadelphia, Pennsylvania.
10
Department of Family Medicine, University of Vermont, Burlington, Vermont.
11
Office of Disease Prevention, NIH, Bethesda, Maryland.
12
Department of Health Policy and History of Medicine, University of Texas Southwestern Medical Center, Dallas, Texas; Department of Health Policy and Management, Mount Saint Mary's University, Los Angeles, California.
13
Department of Clinical Science and Simmons Comprehensive Cancer Center, University of Texas Southwestern Medical Center, Dallas, Texas.
14
Department of Medicine, Brigham and Women's Hospital, Boston, Massachusetts.
15
RAND Corporation, Santa Monica, California.
16
Department of Biostatistics, University of Washington, Seattle, Washington.
17
Department of Gastroenterology, Kaiser Permanente Northern California, Oakland, California.
18
Department of Medicine, Massachusetts General Hospital, Boston, Massachusetts.
19
Department of Family Medicine and Community Health, University of Pennsylvania, Philadelphia, Pennsylvania.

Abstract

INTRODUCTION:

Timely follow-up of abnormal tests is critical to the effectiveness of cancer screening, but may vary by screening test, healthcare system, and sociodemographic group.

METHODS:

Timely follow-up of abnormal mammogram and fecal occult blood testing or fecal immunochemical tests (FOBT/FIT) were compared by race/ethnicity using Population-Based Research Optimizing Screening through Personalized Regimens consortium data. Participants were women with an abnormal mammogram (aged 40-75 years) or FOBT/FIT (aged 50-75 years) in 2010-2012. Analyses were performed in 2015. Timely follow-up was defined as colonoscopy ≤3 months following positive FOBT/FIT; additional imaging or biopsy ≤3 months following Breast Imaging Reporting and Data System Category 0, 4, or 5 mammograms; or ≤9 months following Category 3 mammograms. Logistic regression was used to model receipt of timely follow-up adjusting for study site, age, year, insurance, and income.

RESULTS:

Among 166,602 mammograms, 10.7% were abnormal; among 566,781 FOBT/FITs, 4.3% were abnormal. Nearly 96% of patients with abnormal mammograms received timely follow-up versus 68% with abnormal FOBT/FIT. There was greater variability in receipt of follow-up across healthcare systems for positive FOBT/FIT than for abnormal mammograms. For mammography, black women were less likely than whites to receive timely follow-up (91.8% vs 96.0%, OR=0.71, 95% CI=0.51, 0.97). For FOBT/FIT, Hispanics were more likely than whites to receive timely follow-up than whites (70.0% vs 67.6%, OR=1.12, 95% CI=1.04, 1.21).

CONCLUSIONS:

Timely follow-up among women was more likely for abnormal mammograms than FOBT/FITs, with small variations in follow-up rates by race/ethnicity and larger variation across healthcare systems.

PMID:
27132628
PMCID:
PMC5030116
DOI:
10.1016/j.amepre.2016.03.017
[Indexed for MEDLINE]
Free PMC Article

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