Inadequate Follow-up of Abnormal Screening Mammograms: Findings From the Race Differences in Screening Mammography Process Study (United States)

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Abstract
Despite relatively high mammography screening rates, there are reports of inadequate follow-up of abnormal results. Our objective was to identify factors associated with inadequate follow-up, and specifically, to determine if this outcome differed by race/ethnicity. We studied 176 subjects with abnormal or inconclusive mammograms identified from a prospective cohort study of African-American (n = 635) and White (n = 816) women who underwent screening in five hospital-based facilities in Connecticut, October 1996 through January 1998. Using multivariate logistic regression, we identified independent predictors of inadequate follow-up of an abnormal mammogram. Over 28% of women requiring immediate or short-term follow-up did not receive this care within three months of the recommended return date. African-American race/ethnicity, pain during the mammogram, and lack of a usual provider were significant independent predictors of inadequate follow-up. Although many factors were examined, the observed race difference was unexplained. While inadequate follow-up of abnormal exams undermines the potential benefits of mammography screening for all women, the observed race difference in this study may have implications for the persistent race difference in breast cancer stage at diagnosis and survival. More research is needed to identify factors that contribute to poor follow-up among African-American women.