Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina 29208, USA.
Cancer. 2009 Dec 15;115(24):5788-97. doi: 10.1002/cncr.24633.
In the United States, and particularly in South Carolina, African-American women suffer disproportionately higher mortality rates from breast cancer than European-American women. The timeliness of patient adherence to the follow-up of mammographic abnormalities may influence prognosis and survival. The objective of the current investigation was to examine racial differences in the completion and completion time of a diagnostic workup after the finding of a suspicious breast abnormality.
Study participants of the Best Chance Network, a statewide service program that provides free mammography screening to economically disadvantaged and medically underserved women, were included in the study. Racial differences in tumor characteristics and adherence to recommended workup were tested using chi-square tests and t tests. Logistic and Cox regression modeling was used to assess the relation between workup completion and other factors among African-American women and European-American women.
Completion of the workup was associated with the number of previous procedures and income, and no significant differences were noted by race. The amount of time to completion of the workup was influenced by previous procedures, income, and race. After accounting for completion time, African-American women were 12% less likely than European-American women to complete the recommended workup (hazard ratio, 0.88; P=.01).
The results from this study established a racial disparity in the time to completion of a diagnostic workup among Best Chance Network participants. These findings highlight the importance of understanding the factors associated with delays in and adherence to completing the recommended workup when breast abnormalities are detected in mammograms.
在美国，尤其是南卡罗来纳州，非裔美国女性因乳腺癌导致的死亡率比欧洲裔美国女性高得多。患者及时遵循乳腺异常的随访可能会影响预后和生存。本研究旨在检查在发现可疑乳腺异常后，完成诊断性检查的及时性方面存在的种族差异。
本研究纳入了“最佳机会网络”的研究参与者，该网络是一个全州性服务项目，为经济困难和医疗服务不足的女性提供免费的乳房 X 光筛查。使用卡方检验和 t 检验检验肿瘤特征和对推荐检查的遵守情况方面的种族差异。使用逻辑回归和 Cox 回归模型评估在非裔美国女性和欧洲裔美国女性中，工作完成情况与其他因素之间的关系。
工作完成情况与之前的手术次数和收入有关，且种族间无显著差异。工作完成时间受之前的手术次数、收入和种族的影响。在考虑完成时间后，非裔美国女性完成推荐检查的可能性比欧洲裔美国女性低 12%（风险比，0.88；P=.01）。
本研究结果表明，在“最佳机会网络”参与者中，完成诊断性检查的时间存在种族差异。这些发现强调了在乳腺 X 光片发现乳腺异常时，了解与延迟和遵守推荐检查相关的因素的重要性。
