Racial/ethnic disparities in time to follow-up after an abnormal mammogram

J Womens Health (Larchmt). Jul-Aug 2008;17(6):923-30. doi: 10.1089/jwh.2007.0402.


Background: Although non-Hispanic white women have an increased risk of developing breast cancer, the disease-specific survival is lower for African American and Hispanic women. Little is known about disparities in follow-up after an abnormal mammogram. The goal of this study was to investigate potential disparities in follow-up after an abnormal mammogram.

Methods: A retrospective cohort study of 6722 women with an abnormal mammogram and documented follow-up from January 2000 through December 2002 was performed at an academic medical center in New York City. The outcome was the number of days between the abnormal mammogram and follow-up imaging or biopsy. Cox proportional hazards models were used to assess the effect of race/ethnicity and other potential covariates.

Results: The median number of days to diagnostic follow-up after an abnormal mammogram was greater for African American (20 days) and Hispanic (21 days) women compared with non-Hispanic white (14 days) women (p < 0.001). Racial/ethnic disparities remained significant in a multivariable model controlling for age, Breast Imaging Reporting and Data System (BIRADS) category, insurance status, provider practice location, and median household income.

Conclusions: After an abnormal mammogram, African American and Hispanic women had longer times to diagnostic follow-up compared with non-Hispanic white women. Future efforts will focus on identifying the barriers to follow-up so that effective interventions may be implemented.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • African Americans / statistics & numerical data
  • Aged
  • Breast Neoplasms / diagnostic imaging*
  • Breast Neoplasms / ethnology
  • Cohort Studies
  • Delivery of Health Care / organization & administration*
  • European Continental Ancestry Group / statistics & numerical data
  • Female
  • Follow-Up Studies
  • Health Behavior / ethnology*
  • Healthcare Disparities*
  • Hispanic Americans / statistics & numerical data
  • Humans
  • Mammography / psychology
  • Mammography / statistics & numerical data*
  • Middle Aged
  • New York / ethnology
  • Retrospective Studies
  • Socioeconomic Factors
  • Time Factors