Introduction
Timely follow-up of abnormal tests is critical to the effectiveness of cancer screening,
but may vary by screening test, healthcare system, and sociodemographic group.
Methods
Timely follow-up of abnormal mammogram and fecal occult blood testing or fecal immunochemical
tests (FOBT/FIT) were compared by race/ethnicity using Population-Based Research Optimizing
Screening through Personalized Regimens consortium data. Participants were women with
an abnormal mammogram (aged 40–75 years) or FOBT/FIT (aged 50–75 years) in 2010–2012.
Analyses were performed in 2015. Timely follow-up was defined as colonoscopy ≤3 months
following positive FOBT/FIT; additional imaging or biopsy ≤3 months following Breast
Imaging Reporting and Data System Category 0, 4, or 5 mammograms; or ≤9 months following
Category 3 mammograms. Logistic regression was used to model receipt of timely follow-up
adjusting for study site, age, year, insurance, and income.
Results
Among 166,602 mammograms, 10.7% were abnormal; among 566,781 FOBT/FITs, 4.3% were
abnormal. Nearly 96% of patients with abnormal mammograms received timely follow-up
versus 68% with abnormal FOBT/FIT. There was greater variability in receipt of follow-up
across healthcare systems for positive FOBT/FIT than for abnormal mammograms. For
mammography, black women were less likely than whites to receive timely follow-up
(91.8% vs 96.0%, OR=0.71, 95% CI=0.51, 0.97). For FOBT/FIT, Hispanics were more likely
than whites to receive timely follow-up than whites (70.0% vs 67.6%, OR=1.12, 95%
CI=1.04, 1.21).
Conclusions
Timely follow-up among women was more likely for abnormal mammograms than FOBT/FITs,
with small variations in follow-up rates by race/ethnicity and larger variation across
healthcare systems.
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Article info
Publication history
Published online: April 28, 2016
Identification
Copyright
© 2016 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.
