title: Improving the time to diagnosis after an abnormal screening mammogram.
abstract: BACKGROUND
  Five community-specific interventions to reduce the time to diagnosis after an abnormal breast screen have been evaluated.
  
  
  METHODS
  Subjects with abnormal screening mammograms in 1998 were assessed through five community pilot projects (N = 1137) and a control random sample assessed elsewhere in BC (N = 1053). The number, types, dates and physician costs of breast-related interventions after an abnormal screen were compared between pilots and control.
  
  
  RESULTS
  The median time to diagnosis for women without a biopsy was reduced from 23 days to 7 days (p = 0.001) in the pilot with facilitated referral to diagnosis. The median time to diagnosis for women with a biopsy was reduced from 57 days to 22-43 days in the pilots. Median physician costs per subject were lower (p = 0.02) in pilots that more frequently used core biopsy to obtain a diagnosis.
  
  
  CONCLUSIONS
  Process changes can improve the time to diagnosis after an abnormal breast screen, with similar or lower physician costs per subject. Facilitating the referral process had the greatest impact.
authors.affiliation: Screening Mammography Program of British Columbia, Victoria, BC.
authors.forename: I A
authors.initials: IA
authors.lastname: Olivotto
authors.forename: M J
authors.initials: MJ
authors.lastname: Borugian
authors.forename: L
authors.initials: L
authors.lastname: Kan
authors.forename: S R
authors.initials: SR
authors.lastname: Harris
authors.forename: E J
authors.initials: EJ
authors.lastname: Rousseau
authors.forename: S E
authors.initials: SE
authors.lastname: Thorne
authors.forename: J A
authors.initials: JA
authors.lastname: Vestrup
authors.forename: C J
authors.initials: CJ
authors.lastname: Wright
authors.forename: A J
authors.initials: AJ
authors.lastname: Coldman
authors.forename: T G
authors.initials: TG
authors.lastname: Hislop
mesh_terms: D000328:Adult; D000368:Aged; D001943:Breast Neoplasms / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000453:epidemiology; D001955:British Columbia / Q000453:epidemiology; D003695:Delivery of Health Care / Q000458:organization & administration*; D005069:Evaluation Studies as Topic; D005260:Female; D006801:Humans; D008327:Mammography / Q000191:economics / Q000592:standards; D008403:Mass Screening / Q000191:economics / Q000592:standards; D008875:Middle Aged; D009313:National Health Programs; D017064:Process Assessment, Health Care; D013997:Time Factors