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

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• 作者：Anne Marie McCarthy ; PhD¹ ; ^{amccarthy8@partners.org" class="auth_mail" title="E-mail the corresponding author} ; Jane J. Kim ; PhD² ; Elisabeth F. Beaber ; PhD³ ; Yingye Zheng ; PhD⁴ ; Andrea Burnett-Hartman ; MD⁵ ; ⁶ ; Jessica Chubak ; PhD⁷ ; Nirupa R. Ghai ; PhD⁸ ; Dale McLerran ; MS³ ; Nancy Breen ; PhD⁹ ; Emily F. Conant ; MD¹⁰ ; Berta M. Geller ; EdD¹¹ ; Beverly B. Green ; MD⁷ ; Carrie N. Klabunde ; PhD¹² ; Stephen Inrig ; PhD¹³ ; ¹⁴ ; Celette Sugg Skinner ; PhD¹⁵ ; Virginia P. Quinn ; PhD⁸ ; Jennifer S. Haas ; MD¹⁶ ; Mitchell Schnall ; MD¹⁰ ; Carolyn M. Rutter ; PhD¹⁷ ; William E. Barlow ; PhD¹⁸ ; Douglas A. Corley ; MD¹⁹ ; Katrina Armstrong ; MD¹ ; Chyke A. Doubeni ; MD²⁰ ; on behalf of the PROSPR consortium
• 刊名：American Journal of Preventive Medicine
• 出版年：2016
• 出版时间：October 2016
• 年：2016
• 卷：51
• 期：4
• 页码：507-512
• 全文大小：168 K

文摘

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.