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Improving follow-up to abnormal breast cancer screening in an urban population†
A patient navigation intervention
Article first published online: 22 NOV 2006
DOI: 10.1002/cncr.22354
Copyright © 2006 American Cancer Society
Issue
1097-0142/asset/cover.gif?v=1&s=a7299bc18f075294c232ade468773cd0672bd470 "Cancer")
Cancer
Supplement: Exploring Models to Eliminate Cancer Disparities Among African American and Latino Populations: Research and Community Solutions
Volume 109, Issue Supplement 2, pages 359–367, 15 January 2007
Additional Information
How to Cite
Battaglia, T. A., Roloff, K., Posner, M. A. and Freund, K. M. (2007), Improving follow-up to abnormal breast cancer screening in an urban population. Cancer, 109: 359–367. doi: 10.1002/cncr.22354
- †
Presented at Exploring Models to Eliminate Cancer Disparities Among African American and Latino Populations: Research and Community Solutions, Atlanta, GA, April 21–22, 2005.
Publication History
- Issue published online: 8 JAN 2007
- Article first published online: 22 NOV 2006
- Manuscript Accepted: 21 SEP 2006
- Manuscript Revised: 19 SEP 2006
- Manuscript Received: 30 JUN 2006
Funded by
- Building Interdisciplinary Research Careers in Women's Health (BIRCWH) Faculty Scholar Award. Grant Number: K12-HD43444
- ACS Career Development Award. Grant Number: CCCDA-03-228-01
- Avon Foundation
- Abstract
- Article
- References
- Cited By
Keywords:
- breast neoplasm;
- mass screening;
- case management;
- urban population;
- minority groups;
- medically underserved areas
Abstract
Delays in follow-up after cancer screening contribute to racial/ethnic disparities in cancer outcomes. We evaluated a patient navigator intervention among inner-city women with breast abnormalities. A full-time patient navigator supported patients using the care management model. Female patients 18 years and above, referred to an urban, hospital-based, diagnostic breast health practice from January to June 2000 (preintervention) and November 2001 to February 2003 (intervention), were studied. Timely follow-up was defined as arrival to diagnostic evaluation within 120 days from the date the original appointment was scheduled. Data were collected via computerized registration, medical records, and patient interview. Bivariate and multivariate logistic regression analyses were conducted, comparing preintervention and intervention groups, with propensity score analysis and time trend analysis to address the limitations of the pre–post design. 314 patients were scheduled preintervention; 1018, during the intervention. Overall, mean age was 44 years; 40% black, 36% non-Hispanic white, 14% Hispanic, 4% Asian, 5% other; 15% required an interpreter; 68% had no or only public insurance. Forty-four percent of referrals originated from a community health center, 34% from a hospital-based practice. During the intervention, 78% had timely follow-up versus 64% preintervention (P < .0001). In adjusted analyses, women in the intervention group had 39% greater odds of having timely follow-up (95% CI, 1.01–1.9). Timely follow-up in the adjusted model was associated with older age (P = .0003), having private insurance (P = .006), having an abnormal mammogram (P = .0001), and being referred from a hospital-based practice, as compared to a community health center (P = .003). Our data suggest a benefit of patient navigators in reducing delay in breast cancer care for poor and minority populations. Cancer 2007. © 2006 American Cancer Society.