Racial differences in follow-up of abnormal mammography findings among economically disadvantaged women.
BACKGROUND
In the United States, and particularly in South Carolina, African-American women suffer disproportionately higher mortality rates from breast cancer than European-American women. The timeliness of patient adherence to the follow-up of mammographic abnormalities may influence prognosis and survival. The objective of the current investigation was to examine racial differences in the completion and completion time of a diagnostic workup after the finding of a suspicious breast abnormality.


METHODS
Study participants of the Best Chance Network, a statewide service program that provides free mammography screening to economically disadvantaged and medically underserved women, were included in the study. Racial differences in tumor characteristics and adherence to recommended workup were tested using chi-square tests and t tests. Logistic and Cox regression modeling was used to assess the relation between workup completion and other factors among African-American women and European-American women.


RESULTS
Completion of the workup was associated with the number of previous procedures and income, and no significant differences were noted by race. The amount of time to completion of the workup was influenced by previous procedures, income, and race. After accounting for completion time, African-American women were 12% less likely than European-American women to complete the recommended workup (hazard ratio, 0.88; P=.01).


CONCLUSIONS
The results from this study established a racial disparity in the time to completion of a diagnostic workup among Best Chance Network participants. These findings highlight the importance of understanding the factors associated with delays in and adherence to completing the recommended workup when breast abnormalities are detected in mammograms.
Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina 29208, USA. swann.adams@sc.edu
Swann A
SA
Adams
Emily R
ER
Smith
James
J
Hardin
Irene
I
Prabhu-Das
Jeanette
J
Fulton
James R
JR
Hebert
D001741:Black or African American; D001943:Breast Neoplasms / Q000000981:diagnostic imaging* / Q000208:ethnology*; D005260:Female; D015438:Health Behavior; D006801:Humans; D008327:Mammography; D010349:Patient Compliance; D012959:Socioeconomic Factors; D014481:United States; D035862:Vulnerable Populations; D044465:White People