Timeliness of breast cancer diagnosis and initiation of treatment in the National Breast and Cervical Cancer Early Detection Program, 1996-2005

Am J Public Health. 2010 Sep;100(9):1769-76. doi: 10.2105/AJPH.2009.160184. Epub 2009 Dec 17.


Objectives: To determine the effects of program policy changes, we examined service delivery benchmarks for breast cancer screening in the National Breast and Cervical Cancer Early Detection Program (NBCCEDP).

Methods: We analyzed NBCCEDP data for women with abnormal mammogram or clinical breast examination (n=382 416) from which 23 701 cancers were diagnosed. We examined time to diagnosis and treatment for 2 time periods: 1996 to 2000 and 2001 to 2005. We compared median time for diagnostic, treatment initiation, and total intervals with the Kruskal-Wallis test. We calculated adjusted proportions (predicted marginals) with logistic regression to examine diagnosis and treatment within program benchmarks (<or=60 days) and time from screening to treatment (<or=120 days).

Results: Median diagnostic intervals decreased by 2 days (25 vs 23; P<.001). Median treatment initiation intervals increased by 2 days (12 vs 14; P<.001). Total intervals decreased by 3 days (43 vs 40; P<.001). Women meeting the 60-day benchmark for diagnosis improved the most for women with normal mammograms and abnormal clinical breast examinations from 77% to 82%.

Conclusions: Women screened by the NBCCEDP received diagnostic follow-up and initiated treatment within preestablished program guidelines.

MeSH terms

  • Adult
  • Aged
  • Breast Neoplasms / diagnosis*
  • Breast Neoplasms / epidemiology
  • Breast Neoplasms / therapy*
  • Early Diagnosis
  • Female
  • Humans
  • Logistic Models
  • Mammography
  • Mass Screening
  • Middle Aged
  • Physical Examination
  • Statistics, Nonparametric
  • Time Factors
  • United States / epidemiology