Referral adherence in an inner city breast and cervical cancer screening program

Cancer. 1993 Aug 1;72(3):950-5. doi: 10.1002/1097-0142(19930801)72:3<950::aid-cncr2820720347>;2-s.


Background: Early detection and immediate follow-up treatment for cancer of the breast and cervix can reduce morbidity and mortality. This report describes adherence to follow-up appointments for suspected breast and cervical malignancies in a population of low-income black women who participated in a community-based nurse-managed screening program.

Methods: Components of the program that were part of the intervention included the following: a consistent referral mechanism augmented by a computerized tickler system; education of women about the importance of follow-up; and active nurse assistance in the follow-up process. Referral for follow-up of suspected malignancies or for other questionable findings was made to the public sector hospital clinics (86%) or to other providers of the women's choice (14%).

Results: Follow-up rates for suspected malignancies of the breast were high (92%) in this population of women, sometimes described as less likely to adhere to recommendations for continued care. In contrast, adherence rates for gynecologic conditions were lower (70%).

Conclusions: This screening program and follow-up system has relevance to systems that serve similar groups of low-income women.

Publication types

  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Adult
  • African Americans
  • Appointments and Schedules
  • Breast Neoplasms / prevention & control*
  • Chicago
  • Community Health Centers
  • Female
  • Health Education
  • Humans
  • Mass Screening*
  • Middle Aged
  • Patient Compliance*
  • Poverty
  • Referral and Consultation*
  • Urban Population*
  • Uterine Cervical Neoplasms / prevention & control*