| Description |
Breast cancer (BC) remains the most common cancer in women. Although screening mammography (SM) is an effective approach for early detection of BC, uninsured, underinsured, and minority women often do not have access to SM. The National Breast and Cervical Early Detection Program provide free access to SM. Of women who screen, 10-15% requires further testing, and half of those delay or do not return. Delay may contribute to later stage BC at diagnosis and increased rates of recurrence and death. This study was conducted to identify predictors of delay after an abnormal mammogram and predictors of rescreening behavior in women enrolled in the Tennessee Breast and Cervical Screening Program. Bivariate and multivariate logistic regression analyses were used to explore association between age, race, ethnicity, and marital status, BC history, and presence of breast symptoms and the outcomes of delay and rescreening behavior. Of 11,610 women, 37% required further testing. In a subset of women with time to completion > 1 day, 30% experienced delay > two months. Seventeen percent had another SM during the study period (2002-2006). The high percentage of women needing further testing is likely attributed to the program receiving referrals for diagnosis of symptomatic women as well as asymptomatic screening. Controlling for marital status, age, and BC history, there was more delay in test completion if the women African American versus Caucasian (OR 1.45, 95% CI 1.13, 1.85), Hispanic (OR .72, 95% CI 0.55, 0.93) and reported no breast symptoms (OR 1.50, 95% CI 1.27, 1.77). A delay in receipts of test results > 1 week contributed to the overall delay. Controlling for race and BC history, there was greater likelihood of rescreening if the women were married (OR 1.27, 95% CI 1.12, 1.43) and over 50 years of age (OR 1.92, 95% CI 1.67, 2.21) and less likelihood if the women were non-Hispanic (OR 0.71, 95% CI 0.60, 0.83) and had no breast symptoms (OR 0.85, 95% CI 0.76.,0.96). Findings can be used to identify women at risk for delay, assess understanding of the indication for further test, identify potential barriers to completion of testing or rescreening, and tailor interventions to overcome the barriers. |
