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Disparities in abnormal mammogram follow‐up time for Asian women compared with non‐Hispanic white women and between Asian ethnic groups
Author(s) -
Nguyen Kim H.,
Pasick Rena J.,
Stewart Susan L.,
Kerlikowske Karla,
Karliner Leah S.
Publication year - 2017
Publication title -
cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.052
H-Index - 304
eISSN - 1097-0142
pISSN - 0008-543X
DOI - 10.1002/cncr.30756
Subject(s) - medicine , hazard ratio , confidence interval , ethnic group , vietnamese , demography , prospective cohort study , proportional hazards model , linguistics , philosophy , sociology , anthropology
BACKGROUND Delays in abnormal mammogram follow‐up contribute to poor outcomes. In the current study, the authors examined differences in abnormal screening mammogram follow‐up between non‐Hispanic white (NHW) and Asian women. METHODS The authors used a prospective cohort of NHW and Asian women with a Breast Imaging, Reporting and Data System (BI‐RADS) abnormal result of category 0 or 3‐plus in the San Francisco Mammography Registry between 2000 and 2010. Kaplan‐Meier estimation for the median number of days to follow‐up with a diagnostic radiologic test was performed, and the authors compared the percentage of women with follow‐up at 30 days, 60 days, and 90 days and no follow‐up at 1 year for Asian women overall (and Asian ethnic groups) and NHW women. In addition, the authors assessed the relationship between race/ethnicity and time to follow‐up with adjusted Cox proportional hazards models. RESULTS Among Asian women, Vietnamese and Filipina women had the longest, and Japanese women the shortest, median follow‐up (32 days, 28 days, and 19 days, respectively) compared with NHW women (15 days). The percentage of women receiving follow‐up at 30 days was lower for Asians versus NHWs (57% vs 77%; P <.0001), and these disparities persisted at 60 days and 90 days for all Asian ethnic groups except Japanese. Asian women had a reduced hazard of follow‐up compared with NHW women (adjusted hazard ratio, 0.70; 95% confidence interval, 0.69‐0.72). Asian women also had a higher rate of receiving no follow‐up compared with NHW women (15% vs 10%; P <.001); among Asian ethnic groups, Filipinas were found to have the highest percentage of women with no follow‐up (18.1%). CONCLUSIONS Asian women, particularly Filipina and Vietnamese women, were less likely than NHW women to receive timely follow‐up after an abnormal screening mammogram. Research should disaggregate Asian ethnicity to better understand and address barriers to effective cancer prevention. Cancer 2017;123:3468‐75 . © 2017 American Cancer Society .