Follow-Up of Abnormal Breast and Colorectal Cancer Screening by Race/Ethnicity

Anne Marie McCarthy, Jane J. Kim, Elisabeth F. Beaber, Yingye Zheng, Andrea Burnett-Hartman, Jessica Chubak, Nirupa R. Ghai, Dale McLerran, Nancy Breen, Emily F. Conant, Berta M. Geller, Beverly B. Green, Carrie N. Klabunde, Stephen Inrig, Celette Sugg Skinner, Virginia P. Quinn, Jennifer S. Haas, Mitchell Schnall, Carolyn M. Rutter, William E. BarlowDouglas A. Corley, Katrina Armstrong, Chyke A. Doubeni

Research output: Contribution to journalArticlepeer-review

29 Scopus citations


Introduction Timely follow-up of abnormal tests is critical to the effectiveness of cancer screening, but may vary by screening test, healthcare system, and sociodemographic group. Methods Timely follow-up of abnormal mammogram and fecal occult blood testing or fecal immunochemical tests (FOBT/FIT) were compared by race/ethnicity using Population-Based Research Optimizing Screening through Personalized Regimens consortium data. Participants were women with an abnormal mammogram (aged 40–75 years) or FOBT/FIT (aged 50–75 years) in 2010–2012. Analyses were performed in 2015. Timely follow-up was defined as colonoscopy ≤3 months following positive FOBT/FIT; additional imaging or biopsy ≤3 months following Breast Imaging Reporting and Data System Category 0, 4, or 5 mammograms; or ≤9 months following Category 3 mammograms. Logistic regression was used to model receipt of timely follow-up adjusting for study site, age, year, insurance, and income. Results Among 166,602 mammograms, 10.7% were abnormal; among 566,781 FOBT/FITs, 4.3% were abnormal. Nearly 96% of patients with abnormal mammograms received timely follow-up versus 68% with abnormal FOBT/FIT. There was greater variability in receipt of follow-up across healthcare systems for positive FOBT/FIT than for abnormal mammograms. For mammography, black women were less likely than whites to receive timely follow-up (91.8% vs 96.0%, OR=0.71, 95% CI=0.51, 0.97). For FOBT/FIT, Hispanics were more likely than whites to receive timely follow-up than whites (70.0% vs 67.6%, OR=1.12, 95% CI=1.04, 1.21). Conclusions Timely follow-up among women was more likely for abnormal mammograms than FOBT/FITs, with small variations in follow-up rates by race/ethnicity and larger variation across healthcare systems.

Original languageEnglish (US)
Pages (from-to)507-512
Number of pages6
JournalAmerican Journal of Preventive Medicine
Issue number4
StatePublished - Oct 1 2016

ASJC Scopus subject areas

  • Epidemiology
  • Public Health, Environmental and Occupational Health


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