Mammographic referral patterns for two breast imaging units in Jamaica.
OBJECTIVE
In countries that have instituted national mammographic screening programmes, mortality from breast cancer has decreased by as much as 63%. Although mortality rates from breast cancer in Jamaica are high, there is no national mammographic screening programme. In this context, opportunistic screening, which depends on contact between healthcare provider and patient, as well as self-referral become important. Therefore, the authors sought to determine the source of referrals for women who had mammography.


METHODS
The variables of age, indication for mammography, source of referral and referring physician area of specialty if applicable were extracted from the attendance records for all patients who had mammography at the breast imaging unit at the University Hospital of the West Indies (UHWI) and Radiology West (RadWest) in the year 2003.


RESULTS
There were 779 bilateral mammograms done at UHWI of which 452 (58%) were screening and 1223 mammograms done at RadWest of which 657 (54%) were screening. The difference in proportion of self-referral between the two facilities was significantly different (p < 0. 001). Of the 452 screening mammograms performed at UHWI, 329 (73%) were self-referred, 31 (7%) were from primary care, 18 (4%) from gynaecologists and 17 (4%) from general surgeons. In contrast, of the 657 screening mammograms, at Radwest, 92 (14%) were self-referred, 323 (49%) were from primary care, 47 (7%) from gynaecologists and 37 (6%) from general surgeons.


CONCLUSIONS
To increase the utilization and hence effectiveness of screening mammography, programmes targeting healthcare professionals, particularly gynaecologists and the public are needed.
Soares
D
D
Section of Radiology, Department of Sugery, Radiology, Anaesthesia and Intensive Care, University Hospital of the West Indes, Kingston 7, Jamaica. dpsoares@cwjamaica.com
Kirlew
K
K
Johnson
P
P
Reid
M
M
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000554:Ambulatory Care Facilities / Q000706:statistics & numerical data; D001941:Breast Diseases / Q000175:diagnosis / Q000473:pathology; D001943:Breast Neoplasms / Q000000981:diagnostic imaging*; D005260:Female; D006785:Hospitals, University; D006801:Humans; D007563:Jamaica; D008327:Mammography / Q000706:statistics & numerical data*; D008403:Mass Screening / Q000706:statistics & numerical data; D008875:Middle Aged; D010865:Pilot Projects; D011872:Radiology Department, Hospital / Q000706:statistics & numerical data; D012017:Referral and Consultation / Q000706:statistics & numerical data*; D014932:Women's Health Services / Q000706:statistics & numerical data*