title: Predictors of timely follow-up after abnormal cancer screening among women seeking care at urban community health centers.
abstract: BACKGROUND
  We sought to measure time and identify predictors of timely follow-up among a cohort of racially/ethnically diverse inner city women with breast and cervical cancer screening abnormalities.
  
  
  METHODS
  Eligible women had an abnormality detected on a mammogram or Papanicolaou (Pap) test between January 2004 and December 2005 in 1 of 6 community health centers in Boston, Massachusetts. Retrospective chart review allowed us to measure time to diagnostic resolution. We used Cox proportional hazards models to develop predictive models for timely resolution (defined as definitive diagnostic services completed within 180 days from index abnormality).
  
  
  RESULTS
  Among 523 women with mammography abnormalities and 474 women with Pap test abnormalities, >90% achieved diagnostic resolution within 12 months. Median time to resolution was longer for Pap test than for mammography abnormalities (85 vs 27 days). Site of care, rather than any sociodemographic characteristic of individuals, including race/ethnicity, was the only significant predictor of timely follow-up for both mammogram and Pap test abnormalities.
  
  
  CONCLUSIONS
  Site-specific community-based interventions may be the most effective interventions to reduce cancer health disparities when addressing the needs of underserved populations.
authors.affiliation: Women's Health Unit, Section of General Internal Medicine, Department of Medicine, and Women's Health Interdisciplinary Research Center, Boston University School of Medicine, Boston, MA 02118, USA. tracy.battaglia@bmc.org
authors.forename: Tracy A
authors.initials: TA
authors.lastname: Battaglia
authors.forename: M Christina
authors.initials: MC
authors.lastname: Santana
authors.forename: Sharon
authors.initials: S
authors.lastname: Bak
authors.forename: Manjusha
authors.initials: M
authors.lastname: Gokhale
authors.forename: Timothy L
authors.initials: TL
authors.lastname: Lash
authors.forename: Arlene S
authors.initials: AS
authors.lastname: Ash
authors.forename: Richard
authors.initials: R
authors.lastname: Kalish
authors.forename: Stephen
authors.initials: S
authors.lastname: Tringale
authors.forename: James O
authors.initials: JO
authors.lastname: Taylor
authors.forename: Karen M
authors.initials: KM
authors.lastname: Freund
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001943:Breast Neoplasms / Q000175:diagnosis* / Q000208:ethnology; D003151:Community Health Centers; D003266:Continuity of Patient Care; D055088:Early Detection of Cancer; D005006:Ethnicity; D005260:Female; D015438:Health Behavior / Q000208:ethnology; D054625:Healthcare Disparities; D006801:Humans; D008327:Mammography; D008404:Massachusetts; D008875:Middle Aged; D065006:Papanicolaou Test; D012959:Socioeconomic Factors; D014505:Urban Population; D002583:Uterine Cervical Neoplasms / Q000175:diagnosis* / Q000208:ethnology; D014626:Vaginal Smears; D055815:Young Adult