Compliance and self-reported barriers to follow-up of abnormal screening mammograms among women utilizing a county mobile mammography van.

Our primary objective was to describe the follow-up patterns for abnormal screening mammograms among women in a large urban county who utilized mobile mammography. We conducted a retrospective cohort analysis using electronic records, medical chart review, and questionnaires. Compliance with diagnostic evaluation was 43% to 60%. Among women who did have follow-up, more than 40% did not do so in a timely fashion. Younger women and those with less suspicious mammograms were more likely to have longer delays. We concluded that programs that utilize mobile mammography should include intensive, multilingual tracking systems in order increase diagnostic follow-up for this vulnerable population.

Disparities in screening mammography. Current status, interventions and implications.

OBJECTIVE: This paper describes trends in screening mammography utilization over the past decade and assesses the remaining disparities in mammography use among medically underserved women. We also describe the barriers to mammography and report effective interventions to enhance utilization. DESIGN: We reviewed medline and other databases as well as relevant bibliographies. MAIN RESULTS: The United States has dramatically improved its use of screening mammography over the past decade, with increased rates observed in every demographic group. Disparities in screening mammography are decreasing among medically underserved populations but still persist among racial/ethnic minorities and low-income women. Additionally, uninsured women and those with no usual care have the lowest rates of reported mammogram use. However, despite apparent increases in mammogram utilization, there is growing evidence that limitations in the national survey databases lead to overestimations of mammogram use, particularly among low-income racial and ethnic minorities. CONCLUSIONS: The United States may be farther from its national goals of screening mammography, particularly among underserved women, than current data suggests. We should continue to support those interventions that increase mammography use among the medically underserved by addressing the barriers such as cost, language and acculturation limitations, deficits in knowledge and cultural beliefs, literacy and health system barriers such as insurance and having a source regular of medical care. Addressing disparities in the diagnostic and cancer treatment process should also be a priority in order to affect significant change in health outcomes among the underserved.