Abstract B89: Timeliness in follow-up after abnormal mammography screening among Asian groups

Abstract

Abstract Background: Treatment of breast cancer at the earliest possible stage results from a combination of screening for non-palpable abnormalities and timely and appropriate follow-up of abnormal test results. Studies have addressed Black-White differences in follow-up of abnormal mammograms but little is known about other groups including Asian Americans, a population composed of distinct ethnic sub-groups with substantial heterogeneity in risk factors that correspond with important to differences in breast cancer rates. In this study we aimed to assess completion and timeliness of diagnostic follow-up after an abnormal mammogram between White and Asian women and among disaggregated Asian ethnic subgroups. Methods: Using data from the San Francisco Mammography Registry, we identified women with an index abnormal screening mammogram result of BIRADS 0/3+ between the years 2000-2010. Our study sample included women who self-report White or Asian race/ ethnicity, ages 40 and older. Our outcomes were: 1) proportion of women without diagnostic follow-up within a year of their index mammogram, and 2) median days to diagnostic follow-up. Results: We identified 54028 White and Asian women between 2000 and 2010 in the SFMR data. Seventy percent of women were White and 30% were Asians. Among Asians, 16.2% were Chinese, 6.7% Filipina, 1.8% Japanese, 1.1% Vietnamese, 2.4% Other Asian, and 1.4% Mixed Asian. The majority of women were between the ages of 40-59 (67%). A total of 6023 (11.1%) of women did not receive follow-up within one year after an index abnormal mammogram. A higher proportion of Asian women did not receive follow-up compared to Whites (15% vs 10%). Among Asian groups, Filipinas had the highest percentage of women not receiving follow-up (18%) while Japanese women had the lowest (10.4%). In comparisons of individuals who received follow-up to those who did not, a higher proportion of women with no follow-up had lower education levels (24% vs 15%). Median time to diagnostic follow-up for White and Asian women combined was 18 days. The median follow-up time was 15 days for Whites, and 26 days for Asians. Among Asians, the median follow-up time differed significantly among ethnic groups: Japanese women had the lowest (19 days) and Vietnamese women the longest (30 days) followed by Filipinas (28 days). Conclusion: We observed disparities in timeliness to follow-up between White and Asian women and among Asian ethnic groups. Disaggregation of ethnicity can identify subpopulations most in need of breast cancer control, and to provide more specific information on breast cancer patterns. Citation Format: Kim H. Nguyen, Leah Karliner, Rena J. Pasick. Timeliness in follow-up after abnormal mammography screening among Asian groups. [abstract]. In: Proceedings of the Sixth AACR Conference: The Science of Cancer Health Disparities; Dec 6–9, 2013; Atlanta, GA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2014;23(11 Suppl):Abstract nr B89. doi:10.1158/1538-7755.DISP13-B89