Latinas with abnormal breast findings: patient predictors of timely diagnostic resolution.
BACKGROUND
Incomplete or delayed diagnostic resolution of breast abnormalities suspicious for cancer may contribute to poor breast cancer outcomes among ethnic minority women. We examine the effects of socioeconomic characteristics, knowledge, barriers to healthcare, communication, and clinical variables on diagnostic resolution in Latina women with breast abnormalities at two Los Angeles County public hospitals.


METHODS
We analyzed telephone survey data for 714 women. The outcome--timely diagnostic resolution--was based on medical record data and defined as receipt of a definitive diagnosis (malignant or benign) within 6 months of the index referral. Predictors of the outcome were obtained from a telephone survey and examined with bivariate and multivariable logistic regression models.


RESULTS
Only 60% of women received timely diagnostic resolution; however, the proportion was higher at hospital B (73%) compared with hospital A (56%). In the total sample, the odds of timely diagnostic resolution increased by 8% for every point increase in the scale of satisfaction with how physicians explained the breast abnormality. At hospital B, the odds of timely resolution increased by 57% for every 10-year increase in age.


CONCLUSIONS
Consistent with findings of other studies, our data indicate low diagnostic resolution among Latina women. Satisfaction with how physicians explained breast abnormalities and the interaction of hospital with age affected timely diagnostic resolution. Future research might focus on developing interventions that offer concrete communication strategies to patients and providers. Health systems must also establish systems that facilitate effective patient-provider communication.
Mojica
Cynthia M
CM
School of Public Health and Jonsson Comprehensive Cancer Center, University of California, Los Angeles, Los Angeles, California 90095, USA. cmojica@ucla.edu
Bastani
Roshan
R
Ponce
Ninez A
NA
Boscardin
W John
WJ
D000328:Adult; D001943:Breast Neoplasms / Q000175:diagnosis* / Q000208:ethnology*; D002140:California / Q000453:epidemiology; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006297:Health Services Accessibility / Q000706:statistics & numerical data; D006630:Hispanic or Latino / Q000706:statistics & numerical data*; D006801:Humans; D008327:Mammography / Q000706:statistics & numerical data; D008875:Middle Aged; D015999:Multivariate Analysis; D010342:Patient Acceptance of Health Care / Q000208:ethnology*; D011203:Poverty; D011369:Professional-Patient Relations; D012017:Referral and Consultation / Q000706:statistics & numerical data; D011795:Surveys and Questionnaires; D016387:Women's Health / Q000208:ethnology*