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Cited by 14Global Cancer Incidence and ScreeningWomen's cancer prevention and managementDigital Radiography and Breast Imaging

Delays in Follow-up Care for Abnormal Mammograms in Mobile Mammography Versus Fixed-Clinic Patients

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Vang, Suzanne S., Dunn, Alexandra, Margolies, Laurie R., Jandorf, Lina·2022·Journal of General Internal Medicine
DOI 10.1007/s11606-021-07189-3PMC PMC9130416
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Abstract

Background Mobile mammographic services (MM) have been shown to increase breast cancer screening in medically underserved women. However, little is known about MM patients' adherence to follow-up of abnormal mammograms and how this compares with patients from traditional, fixed clinics. Objectives To assess delays in follow-up of abnormal mammograms in women screened using MM versus fixed clinics. Design Electronic medical record review of abnormal screening mammograms. Subjects Women screened on a MM van or at a fixed clinic with an abnormal radiographic result in 2019 (N = 1,337). Main measures Our outcome was delay in follow-up of an abnormal mammogram of 60 days or greater. Guided by Andersen's Behavioral Model of Health Services Utilization, we assessed the following: predisposing (age, ethnicity, marital status, preferred language), enabling (insurance, provider referral, clinic site), and need (personal breast cancer history, family history of breast/ovarian cancer) factors. Key results Only 45% of MM patients had obtained recommended follow-up within 60 days of an abnormal screening compared to 72% of fixed-site patients (p < .001). After adjusting for predisposing, enabling, and need factors, MM patients were 2.1 times more likely to experience follow-up delays than fixed-site patients (CI: 1.5-3.1; p < .001). African American (OR: 1.5; CI: 1.0-2.1; p < .05) and self-referred (OR: 1.8; CI: 1.2-2.8; p < .01) women were significantly more likely to experience delays compared to Non-Hispanic White women or women with a provider referral, respectively. Women who were married (OR: 0.63; CI: 0.5-0.9; p < .01), had breast cancer previously (OR: 0.37; CI: 0.2-0.8; p < .05), or had a family history of breast/ovarian cancer (OR: 0.76; CI: 0.6-0.9; p < .05) were less likely to experience delayed care compared to unmarried women, women with no breast cancer history, or women without a family history of breast/ovarian cancer, respectively. Conclusions A substantial proportion of women screened using MM had follow-up delays. Women who are African American, self-referred, or unmarried are particularly at risk of experiencing delays in care for an abnormal mammogram.

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  • Self-referred patients were found to experience 3.2 times more delay than those referred by their primary care providers.

    “self-referred patients were found to experience 3.2 times more delay than those referred by their primary care providers (PCPs), as PCPs often play a crucial role in facilitating follow-up care and providing guidance and resources [50].”

    From Toward Safer Diagnoses: A SEIPS-Based Narrative Review of Diagnostic Errors (2026) · cites this paper as [50]

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Authors
Vang, S. S., Dunn, A., Margolies, L. R., & Jandorf, L.
Affiliations
  • Icahn School of Medicine at Mount Sinai (US)
  • Mount Sinai Hospital (US)
Corresponding author
Vang, Suzanne S.
ORCID
Venue
Journal of General Internal Medicine
Publisher
Springer Science and Business Media LLC
Published
2022-02-25
Volume
37
Issue
7
Pages
1619-1625
ISSN
  • 0884-8734 (ISSN-L)
  • 1525-1497
DOI
10.1007/s11606-021-07189-3
PMC
PMC9130416
OpenAlex
W4214494002
Cited by
14
References
69
Citations by year
2026: 7 · 2025: 3 · 2024: 1 · 2023: 2 · 2022: 1
FWCI
0.73
Type
journal article
Language
en
Open access
Licence
Locations
  • Journal of General Internal Medicine (publishedVersion)
  • PubMed Central (publishedVersion)
  • PubMed (publishedVersion)
Funders
National Cancer Institute (T32CA225617)
Topics
  • Health Sciences › Medicine › Oncology › Global Cancer Incidence and Screening
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Women's cancer prevention and management
  • Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Digital Radiography and Breast Imaging
Keywords
mobile mammography, mammographic abnormalities, breast cancer screening, medically underserved women, Andersen Behavioral Model, African American women, self-referral, provider referral, family history of breast cancer, insurance status, marital status, language preference
MeSH terms
Aftercare, Breast Neoplasms, Female, Humans, Mammography, Mass Screening, Ovarian Neoplasms, Early Detection of Cancer

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