Timeliness of breast cancer diagnosis and initiation of treatment in the National Breast and Cervical Cancer Early Detection Program (NBCCEDP)

Abstract

6571 Background: To examine intervals between breast cancer screening, diagnosis, and treatment initiation among low income and uninsured women in the National Breast and Cervical Cancer Early Detection Program during two time periods. Methods: We examined diagnostic and treatment intervals for the time periods of 1996–2000 and 2001–2005 to evaluate program progress. The intervals were defined as: (1) time between mammography and final diagnosis for all women receiving an abnormal mammogram result (including suspicious abnormality (SA), highly suspicious for malignancy (HSM) and assessment is incomplete (AI)) or abnormal clinical breast exam and; (2) time between diagnosis and treatment initiation among those diagnosed with cancer. Covariates including mammography result, age at screening, race/ethnicity, and metropolitan/urban/rural classification of residence were included in the analysis. Results: For the entire study period, 369,557 women screened for breast cancer through the NBCCEDP had abnormal screen results. For 1996–2000 and 2001–2005 time periods, the median interval to diagnosis after screening was 25 days and 23 days respectively. For those 22,302 women found to have cancer, the median interval from diagnosis to treatment increased from 12 days in the first time period to 14 days in the later time period. Overall, time to diagnosis improved from 1996–2000 compared to 2001–2005. However, time to treatment initiation was slightly longer (median increased by 2–3 days). Using data from the most recent period of 2001–2005, 93% of women with cancer initiated treatment within 120 days of screening. Conclusions: The goal of the NBCCEDP is to assure that women receive timely, quality breast cancer screening and diagnostic services and initiate treatment. Our data show that the program is meeting these goals. Disparities in breast cancer incidence, mortality and survival should diminish once all women have access to breast cancer early detection and treatment services. No significant financial relationships to disclose.