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. 2010 Sep;100(9):1769-76.
doi: 10.2105/AJPH.2009.160184. Epub 2009 Dec 17.

Timeliness of breast cancer diagnosis and initiation of treatment in the National Breast and Cervical Cancer Early Detection Program, 1996-2005

Lisa C Richardson  1 , Janet Royalty, William Howe, William Helsel, William Kammerer, Vicki B Benard
Affiliations

Timeliness of breast cancer diagnosis and initiation of treatment in the National Breast and Cervical Cancer Early Detection Program, 1996-2005

Lisa C Richardson et al. Am J Public Health. 2010 Sep.

Abstract

Objectives: To determine the effects of program policy changes, we examined service delivery benchmarks for breast cancer screening in the National Breast and Cervical Cancer Early Detection Program (NBCCEDP).

Methods: We analyzed NBCCEDP data for women with abnormal mammogram or clinical breast examination (n=382 416) from which 23 701 cancers were diagnosed. We examined time to diagnosis and treatment for 2 time periods: 1996 to 2000 and 2001 to 2005. We compared median time for diagnostic, treatment initiation, and total intervals with the Kruskal-Wallis test. We calculated adjusted proportions (predicted marginals) with logistic regression to examine diagnosis and treatment within program benchmarks (<or=60 days) and time from screening to treatment (<or=120 days).

Results: Median diagnostic intervals decreased by 2 days (25 vs 23; P<.001). Median treatment initiation intervals increased by 2 days (12 vs 14; P<.001). Total intervals decreased by 3 days (43 vs 40; P<.001). Women meeting the 60-day benchmark for diagnosis improved the most for women with normal mammograms and abnormal clinical breast examinations from 77% to 82%.

Conclusions: Women screened by the NBCCEDP received diagnostic follow-up and initiated treatment within preestablished program guidelines.

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Figures

FIGURE 1
FIGURE 1
Adjusted proportions (predicted marginals) for meeting diagnostic, treatment, and total intervals within program standards: National Breast and Cervical Cancer Early Detection Program, 1996–2005. Note. Percentages (predicted marginals) are controlled for mammogram and CBE result, age, race/ethnicity, and residence. P values are for change in proportions meeting the program benchmarks during the study period. For the diagnostic interval, P < .001; for the treatment interval, P = .078; for the total interval, P < .001.
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