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Capturing the Rest: Inpatient Mammography for Nonadherent Hospitalized Women

      Introduction

      More than a third of hospitalized women are overdue or nonadherent to breast cancer screening guidelines, and almost a third of them are also at high risk for developing breast cancer. The purpose of this study is to evaluate the feasibility of coordinating inpatient breast cancer screening mammography for these women before their discharge from the hospital.

      Methods

      A prospective intervention study was conducted among 101 nonadherent women aged 50–74 years who were hospitalized to a general medicine service. Sociodemographic, reproductive history, family history of breast cancer, and medical comorbidities data were collected for all patients from January 2015 to October 2016. The data were analyzed in March 2018. Fisher's exact tests and unpaired t-tests were utilized to compare the characteristics of the study population.

      Results

      Of the 101 women enrolled who were nonadherent to breast cancer screening recommendations, their mean age was 59.3 (SD=6) years, the mean 5-year Gail risk score was 1.63 (SD=0.69), and 29% of the women were African American. Almost 80% (n=79) underwent inpatient screening mammography. All women who underwent screening mammography during their inpatient stay were extremely satisfied with the experience. The convenience of having screening mammography while hospitalized was reported to be a major facilitator of completing the overdue screening. All nurses (100%) taking care of these women believed that this practice should become part of the standard of care, and most hospitalist physicians (66%) agreed that this practice is feasible.

      Conclusions

      This study shows that it is possible to coordinate mammography for hospitalized women who were overdue for screening and at high risk for developing breast cancer.

      Trial registration

      This study is registered at www.clinicaltrials.gov NCT04164251.
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      REFERENCES

        • Hall IJ
        • Tangka FKL
        • Sabatino SA
        • Thompson TD
        • Graubard BI
        • Breen N.
        Patterns and trends in cancer screening in the United States.
        Prev Chronic Dis. 2018; 15: E97https://doi.org/10.5888/pcd15.170465
        • Silber JH
        • Rosenbaum PR
        • Ross RN
        • et al.
        Disparities in breast cancer survival by socioeconomic status despite Medicare and Medicaid insurance.
        Milbank Q. 2018; 96: 706-754https://doi.org/10.1111/1468-0009.12355
        • Dailey AB
        • Brumback BA
        • Livingston MD
        • Jones BA
        • Curbow BA
        • Xu X.
        Area-level socioeconomic position and repeat mammography screening use: results from the 2005 National Health Interview Survey.
        Cancer Epidemiol Biomarkers Prev. 2011; 20: 2331-2344https://doi.org/10.1158/1055-9965.EPI-11-0528
      1. American Cancer Society. Cancer facts & figures 2021. Atlanta, GA: American Cancer Society.https://www.cancer.org/content/dam/cancer-org/research/cancer-facts-and-statistics/annual-cancer-facts-and-figures/2021/cancer-facts-and-figures-2021.pdf. Published 2021. Accessed XXX.

        • Miller JW
        • King JB
        • Joseph DA
        • Richardson LC
        • Centers for Disease Control and Prevention (CDC)
        Breast cancer screening among adult women–Behavioral Risk Factor Surveillance System, United States, 2010.
        MMWR Suppl. 2012; 61: 46-50
        • Bleyer A
        • Welch HG.
        Effect of three decades of screening mammography on breast-cancer incidence.
        N Engl J Med. 2012; 367: 1998-2005https://doi.org/10.1056/NEJMoa1206809
        • Ward E
        • Jemal A
        • Cokkinides V
        • et al.
        Cancer disparities by race/ethnicity and socioeconomic status.
        CA Cancer J Clin. 2004; 54: 78-93https://doi.org/10.3322/canjclin.54.2.78
        • Chowdhury R
        • David N
        • Bogale A
        • Nandy S
        • Habtemariam T
        • Tameru B.
        Assessing the key attributes of low utilization of mammography screening and breast-self exam among African-American women.
        J Cancer. 2016; 7: 532-537https://doi.org/10.7150/jca.12963
        • Akinyemiju T
        • Moore JX
        • Ojesina AI
        • Waterbor JW
        • Altekruse SF.
        Racial disparities in individual breast cancer outcomes by hormone-receptor subtype, area-level socio-economic status and healthcare resources.
        Breast Cancer Res Treat. 2016; 157: 575-586https://doi.org/10.1007/s10549-016-3840-x
        • Mariotto AB
        • Enewold L
        • Zhao J
        • Zeruto CA
        • Yabroff KR.
        Medical care costs associated with cancer survivorship in the United States.
        Cancer Epidemiol Biomarkers Prev. 2020; 29: 1304-1312https://doi.org/10.1158/1055-9965.EPI-19-1534
        • Khaliq W
        • Visvanathan K
        • Landis R
        • Wright SM.
        Breast cancer screening preferences among hospitalized women.
        J Womens Health (Larchmt). 2013; 22: 637-642https://doi.org/10.1089/jwh.2012.4083
        • Khaliq W
        • Aamar A
        • Wright SM.
        Predictors of non-adherence to breast cancer screening among hospitalized women.
        PLoS One. 2015; 10e0145492https://doi.org/10.1371/journal.pone.0145492
        • Khaliq W
        • Landis R
        • Wright SM.
        Improving breast cancer screening adherence among hospitalized women.
        J Womens Health (Larchmt). 2017; 26: 1094-1098https://doi.org/10.1089/jwh.2016.5939
        • Kisuule F
        • Minter-Jordan M
        • Zenilman J
        • Wright SM.
        Expanding the roles of hospitalist physicians to include public health.
        J Hosp Med. 2007; 2: 93-101https://doi.org/10.1002/jhm.185
        • U.S. Preventive Services Task Force
        Screening for breast cancer: U.S. Preventive Services Task Force recommendation statement [published correction appears in Ann Intern Med. 2010;152(3):199–200] [published correction appears in Ann Intern Med. 2010;152(10):688].
        Ann Intern Med. 2009; 151 (W-236): 716-726https://doi.org/10.7326/0003-4819-151-10-200911170-00008
        • Gail MH
        • Brinton LA
        • Byar DP
        • et al.
        Projecting individualized probabilities of developing breast cancer for white females who are being examined annually.
        J Natl Cancer Inst. 1989; 81: 1879-1886https://doi.org/10.1093/jnci/81.24.1879
        • Costantino JP
        • Gail MH
        • Pee D
        • et al.
        Validation studies for models projecting the risk of invasive and total breast cancer incidence.
        J Natl Cancer Inst. 1999; 91: 1541-1548https://doi.org/10.1093/jnci/91.18.1541
        • Gail MH
        • Costantino JP
        • Bryant J
        • et al.
        Weighing the risks and benefits of tamoxifen treatment for preventing breast cancer [published correction appears in J Natl Cancer Inst. 2000;92(3):275].
        J Natl Cancer Inst. 1999; 91: 1829-1846https://doi.org/10.1093/jnci/91.21.1829
        • Rockhill B
        • Spiegelman D
        • Byrne C
        • Hunter DJ
        • Colditz GA.
        Validation of the Gail et al. model of breast cancer risk prediction and implications for chemoprevention.
        J Natl Cancer Inst. 2001; 93: 358-366https://doi.org/10.1093/jnci/93.5.358
        • Gail MH
        • Costantino JP
        • Pee D
        • et al.
        Projecting individualized absolute invasive breast cancer risk in African American women [published correction appears in J Natl Cancer Inst. 2008;100(15):1118] [published correction appears in J Natl Cancer Inst. 2008;100(5):373].
        J Natl Cancer Inst. 2007; 99: 1782-1792https://doi.org/10.1093/jnci/djm223
        • Matsuno RK
        • Costantino JP
        • Ziegler RG
        • et al.
        Projecting individualized absolute invasive breast cancer risk in Asian and Pacific Islander American women.
        J Natl Cancer Inst. 2011; 103: 951-961https://doi.org/10.1093/jnci/djr154
        • Charlson ME
        • Pompei P
        • Ales KL
        • MacKenzie CR.
        A new method of classifying prognostic comorbidity in longitudinal studies: development and validation.
        J Chronic Dis. 1987; 40: 373-383https://doi.org/10.1016/0021-9681(87)90171-8
        • Khaliq W
        • Harris CM
        • Landis R
        • Bridges JF
        • Wright SM.
        Hospitalized women's willingness to pay for an inpatient screening mammogram.
        Ann Fam Med. 2014; 12: 556-558https://doi.org/10.1370/afm.1694
        • Khaliq W
        • Howell EE
        • Wright SM.
        What do hospitalists think about inpatient mammography for hospitalized women who are overdue for their breast cancer screening?.
        J Hosp Med. 2015; 10: 242-245https://doi.org/10.1002/jhm.2322
        • Boling W
        • Laufman L
        • Lynch GR
        • Weinberg AD.
        Increasing mammography screening through inpatient education.
        J Cancer Educ. 2005; 20: 247-250https://doi.org/10.1207/s15430154jce2004_14
        • Morelli V.
        An introduction to primary care in underserved populations: definitions, scope, and challenges.
        Prim Care. 2017; 44: 1-9https://doi.org/10.1016/j.pop.2016.09.002
        • Henry KA
        • Sherman R
        • Farber S
        • Cockburn M
        • Goldberg DW
        • Stroup AM.
        The joint effects of census tract poverty and geographic access on late-stage breast cancer diagnosis in 10 U.S. states.
        Health Place. 2013; 21: 110-121https://doi.org/10.1016/j.healthplace.2013.01.007
        • DeSantis CE
        • Ma J
        • Goding Sauer A
        • Newman LA
        • Jemal A
        Breast cancer statistics, 2017, racial disparity in mortality by state.
        CA Cancer J Clin. 2017; 67: 439-448https://doi.org/10.3322/caac.21412
        • Dole GF
        • Carney PA.
        Characteristics of underserved women who did and those who did not use a free/low-cost voucher as part of a mammography screening program.
        J Cancer Educ. 1998; 13: 102-107https://doi.org/10.1080/08858199809528525