Referral adherence in an inner city breast and cervical cancer screening program.
BACKGROUND
Early detection and immediate follow-up treatment for cancer of the breast and cervix can reduce morbidity and mortality. This report describes adherence to follow-up appointments for suspected breast and cervical malignancies in a population of low-income black women who participated in a community-based nurse-managed screening program.


METHODS
Components of the program that were part of the intervention included the following: a consistent referral mechanism augmented by a computerized tickler system; education of women about the importance of follow-up; and active nurse assistance in the follow-up process. Referral for follow-up of suspected malignancies or for other questionable findings was made to the public sector hospital clinics (86%) or to other providers of the women's choice (14%).


RESULTS
Follow-up rates for suspected malignancies of the breast were high (92%) in this population of women, sometimes described as less likely to adhere to recommendations for continued care. In contrast, adherence rates for gynecologic conditions were lower (70%).


CONCLUSIONS
This screening program and follow-up system has relevance to systems that serve similar groups of low-income women.
Lacey
L
L
Avoidable Mortality from Cancer Project, School of Public Health, University of Illinois, Chicago 60612.
Whitfield
J
J
DeWhite
W
W
Ansell
D
D
Whitman
S
S
Chen
E
E
Phillips
C
C
D000328:Adult; D001741:Black or African American; D001071:Appointments and Schedules; D001943:Breast Neoplasms / Q000517:prevention & control*; D002641:Chicago; D003151:Community Health Centers; D005260:Female; D006266:Health Education; D006801:Humans; D008403:Mass Screening; D008875:Middle Aged; D010349:Patient Compliance; D011203:Poverty; D012017:Referral and Consultation; D014505:Urban Population; D002583:Uterine Cervical Neoplasms / Q000517:prevention & control*