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. 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

Anne Marie McCarthy  1 , Jane J Kim  2 , Elisabeth F Beaber  3 , Yingye Zheng  4 , Andrea Burnett-Hartman  5 , Jessica Chubak  6 , Nirupa R Ghai  7 , Dale McLerran  3 , Nancy Breen  8 , Emily F Conant  9 , Berta M Geller  10 , Beverly B Green  6 , Carrie N Klabunde  11 , Stephen Inrig  12 , Celette Sugg Skinner  13 , Virginia P Quinn  7 , Jennifer S Haas  14 , Mitchell Schnall  9 , Carolyn M Rutter  15 , William E Barlow  16 , Douglas A Corley  17 , Katrina Armstrong  18 , Chyke A Doubeni  19 ; PROSPR consortium
Affiliations

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

Anne Marie McCarthy et al. Am J Prev Med. 2016 Oct.

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.

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