Ethn
Health 1996 Sep;1(3):221-8
Barriers to follow-up of abnormal screening mammograms among low-income
minority women. Cancer Control Center of Harlem.
Rojas M, Mandelblatt J, Cagney K, Kerner J, Freeman H.
Department of Medicine, Lombardi Cancer Center, Washington, DC 20007,
USA.
OBJECTIVE: To describe factors related to compliance
diagnostic follow-up among minority women of low socioeconomic status
with abnormal screening mammograms.
METHODS: A retrospective cross-sectional survey using
a structured telephone interview.
Three cancer screening clinics at an urban inner-city public hospital.
All women with abnormal screening mammograms between September 1990 and
January 1992 were eligible; women were interviewed in August 1992. Abnormal
mammograms were those requiring specific, non-routine clinical follow-up;
non-compliance was defined as delayed follow-up (four to six months after
the date of the mammogram), or no follow-up at the time of interview (more
than 6 months after abnormal).
RESULTS: Sixty-two of 442 screened women had abnormal
results; the overall rate of non-compliance with follow-up was 50%. Among
the 42 (68%) women who agreed to be interviewed, non-compliers were less
likely to state that they had been told to receive follow-up than compliers
(65% versus 100%; p = 0.008). Non-compliant women were less likely to
have suspicious mammography interpretations (p = 0.05), and more likely
to report barriers to follow-up, such as cost of lost wages and medical
care, system barriers, or fears, than compliant women (61.9% versus 9%,
p = 0.01). There were no differences between the two groups for age, education,
insurance, source of care, family history, knowledge or attitudes.
CONCLUSIONS: These preliminary results suggest that follow-up
of low income, minority women with abnormal screening mammograms could
be enhanced by improved communication of results. Future studies should
extend these findings with larger samples and in other settings and populations.
PMID: 9395566 [PubMed - indexed for MEDLINE]