Realizing the promise of breast cancer screening: clinical follow-up after abnormal screening among Black women

2003 ◽  
Vol 37 (2) ◽  
pp. 92-101 ◽  
Author(s):  
Jon F Kerner ◽  
Michael Yedidia ◽  
Deborah Padgett ◽  
Barbara Muth ◽  
Kathleen Shakira Washington ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Black Women ◽  
Cancer Screening ◽  
Breast Cancer Screening

Do patient tracking, follow-up, and referral practices contribute to breast cancer disparities in a large urban area?

2012 ◽  
Vol 30 (15_suppl) ◽  
pp. 6120-6120
Author(s):  
Christine B. Weldon ◽  
Julia R. Trosman ◽  
Danielle Dupuy ◽  
Betty Roggenkamp ◽  
Julian C. Schink ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Black Women ◽  
Cancer Screening ◽  
Breast Cancer Screening ◽  
White Women ◽  
Public Hospitals ◽  
Care Plan ◽  
Patient Tracking ◽  
Referral Practices

6120 Background: Chicago Black women are 62% more likely to die from breast (BC) cancer than White women. Previous data from 39 Chicago hospitals suggested significant quality deficits in breast cancer screening and treatment (Chicago Breast Cancer Quality Consortium, 2010). Patient tracking, follow up and referral practices may influence quality of care for minority women (Mojica et al, Cancer Control, 2007). Our goal is to evaluate tracking, follow up and referral practices during screening, diagnosis and treatment of BC at Chicago hospitals servicing Black women. Methods: Using the framework approach of qualitative research, we conducted interviews with providers of BC screening and care from 20 Chicago institutions with Black patients averaging 50% of patient base (15 community, 3 academic and 2 public hospitals). Informants included surgeons, medical oncologists, radiologists, mammography technicians, internists, nurses, administrators, and patient navigators. Interviews were transcribed, and thematic and statistical analyses were performed (simple frequencies and Fisher's exact test). Results: Six of the 20 sites (30%) follow up with patients who did not show for a scheduled mammography visit. Five of these sites (83%, 5/6) have a low “no-show” rate (below 20%), compared to 4 sites (29%, 4/14) with low “no-show” rates among the 14 sites without follow-up (p=0.05). Seven of the 20 sites (25%) direct diagnosed patients to their next step in care by providing referrals and guidance, while other 13 sites rely on a primary care physician or leave the patient without a clear care plan. BC patients at 6 of the 7 sites directing care (83%, 5/6) are referred to a mid- or high-volume surgeon (3+ BC surgeries / month), compared to patients from only 1 of the 13 sites not directing care (p=0.001). Nine of the 20 sites track diagnosed BC patients through their care. Five of them (56%, 5/9) also track survivors, compared to none (0%, 0/11) of the 11 sites who do not track patients (p=0.008). Conclusions: Poor tracking, follow up and referral practices for breast cancer screening and treatment are associated with suboptimal care and may contribute to outcome disparities for Black women in Chicago.

Call to action: breast cancer screening recommendations for Black women

2021 ◽  
Vol 187 (1) ◽  
pp. 295-297
Author(s):  
Bridget A. Oppong ◽  
Samilia Obeng-Gyasi ◽  
Theresa Relation ◽  
Lucile Adams-Campbell
Keyword(s):  
Breast Cancer ◽  
Black Women ◽  
Cancer Screening ◽  
Breast Cancer Screening ◽  
Call To Action

scholarly journals Effectiveness of diet and physical activity interventions amongst adults attending colorectal and breast cancer screening: a systematic review and meta-analysis

2020 ◽  
Author(s):  
Samuel T. Orange ◽  
Kirsty M. Hicks ◽  
John M. Saxton
Keyword(s):  
Breast Cancer ◽  
Physical Activity ◽  
Cancer Screening ◽  
Breast Cancer Screening ◽  
Vegetable Intake ◽  
Dietary Interventions ◽  
Physical Activity Interventions ◽  
Mean Differences ◽  
Quality Evidence

Abstract Purpose To estimate the effectiveness of tailored physical activity and dietary interventions amongst adults attending colorectal and breast cancer screening. Methods Five literature databases were systematically searched to identify randomised controlled trials (RCTs) of tailored physical activity and/or dietary interventions with follow-up support initiated through colorectal and breast cancer screening programmes. Outcomes included markers of body fatness, physical activity, and dietary intake. Mean differences (MDs) or standardised mean differences (SMDs) with 95% confidence intervals (CIs) were pooled using random effects models. Results Five RCTs met the inclusion criteria encompassing a total of 722 participants. Diet and physical activity interventions led to statistically significant reductions in body mass (MD − 1.6 kg, 95% CI − 2.7 to − 0.39 kg; I2 = 81%; low quality evidence), body mass index (MD − 0.78 kg/m2, 95% CI − 1.1 to − 0.50 kg/m2; I2 = 21%; moderate quality evidence), and waist circumference (MD − 2.9 cm, 95% CI − 3.8 to − 1.91; I2 = 0%; moderate quality evidence), accompanied by an increase in physical activity (SMD 0.31, 95% CI 0.13 to 0.50; I2 = 0%; low quality evidence) and fruit and vegetable intake (SMD 0.33, 95% CI 0.01 to 0.64; I2 = 51%; low quality evidence). Conclusion There is low quality evidence that lifestyle interventions involving follow-up support lead to modest weight loss and increased physical activity and fruit and vegetable intake. Due to the modest intervention effects, low quality of evidence and small number of studies, further rigorously designed RCTs with long-term follow-up of modifiable risk factors and embedded cost–benefit analyses are warranted (PROSPERO ref: CRD42020179960).

Breast cancer overdiagnosis in stop-screen trials: More uncertainty than previously reported

2020 ◽  
pp. 096914132095078
Author(s):  
Stuart G Baker ◽  
Philip C Prorok
Keyword(s):  
Breast Cancer ◽  
Cancer Screening ◽  
Confidence Interval ◽  
Breast Cancer Screening ◽  
Confidence Intervals ◽  
Latent Class ◽  
Screening Program ◽  
Screen Interval ◽  
Binomial Confidence Interval

Objective According to the Independent UK Panel on Breast Cancer Screening, the most reliable estimates of overdiagnosis for breast cancer screening come from stop-screen trials Canada 1, Canada 2, and Malmo. The screen-interval overdiagnosis fraction is the fraction of cancers in a screening program that are overdiagnosed. We used the cumulative incidence method to estimate screen-interval overdiagnosis fraction. Our goal was to derive confidence intervals for estimated screen-interval overdiagnosis fraction and adjust for refusers in these trials. Methods We first show that the UK Panel’s use of a 95% binomial confidence interval for estimated screen-interval overdiagnosis fraction was incorrect. We then derive a correct 95% binomial-Poisson confidence interval. We also use the method of latent-class instrumental variables to adjust for refusers. Results For the Canada 1 trial, the estimated screen-interval overdiagnosis fraction was 0.23 with a 95% binomial confidence interval of (0.18, 0.27) and a 95% binomial-Poisson confidence interval of (0.04, 0.41). For the Canada 2 trial, the estimated screen-interval overdiagnosis fraction was 0.16 with a 95% binomial confidence interval of (0.12, 0.19) and a 95% binomial-Poisson confidence interval of (−0.01, 0.32). For the Malmo trial, the estimated screen-interval overdiagnosis fraction was 0.19 with a 95% binomial confidence interval of (0.15, 0.22). Adjusting for refusers, the estimated screen-interval overdiagnosis fraction was 0.26 with a 95% binomial-Poisson confidence interval of (0.03, 0.50). Conclusion The correct 95% binomial-Poisson confidence interval s for the estimated screen-interval overdiagnosis fraction based on the Canada 1, Canada 2, and Malmo stop-screen trials are much wider than the previously reported incorrect 95% binomial confidence intervals. The 95% binomial-Poisson confidence intervals widen as follow-up time increases, an unappreciated downside of longer follow-up in stop-screen trials.

scholarly journals Conclusions for mammography screening after 25-year follow-up of the Canadian National Breast Cancer Screening Study (CNBSS)

2015 ◽  
Vol 26 (2) ◽  
pp. 342-350 ◽  
Author(s):  
S. H. Heywang-Köbrunner ◽  
I. Schreer ◽  
A. Hacker ◽  
M. R. Noftz ◽  
A. Katalinic
Keyword(s):  
Breast Cancer ◽  
Cancer Screening ◽  
Breast Cancer Screening ◽  
Mammography Screening ◽  
National Breast ◽  
Screening Study

scholarly journals Improving the Outcomes of Breast Cancer in China: Physicians’ Beliefs, Recommendations, and Practices for Breast Cancer Screening

2020 ◽  
Vol 5 (4) ◽  
pp. 251-258
Author(s):  
Tsu-Yin Wu ◽  
Vedhika Raghunathan ◽  
Jianguo Shi ◽  
Wang Hua ◽  
Wang Yu ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Cancer Screening ◽  
Breast Cancer Screening ◽  
Focal Point ◽  
Chinese Women ◽  
Physician Education ◽  
Screening Guidelines ◽  
Screening Practices ◽  
Comfort Levels

Objective: Physicians play a key role in performing and referring patients for cancer screening. A paucity of data exists for breast cancer screening (BCS) recommendations, demographic characteristics, screening practices, and barriers of screening among physicians. The purpose of this project is to examine physicians’ characteristics, practices, and beliefs about BCS recommendations and its barriers. Methods: The study used a descriptive correlational design and 110 surveys were completed. Data was analyzed using descriptive and inferential statistics generated with Statistical Packages for Sciences (SPSS) 26.0 version.Results: Most of the surveyed Chinese physicians worked in the community, were females, and between 30-39 years of age. Participants reported working in collaboration on numerous aspects of BCS, and also reported the recommendation of starting screening at younger ages in contrast to existing guidelines. A higher percentage of participants recommended more clinical breast exams compared to mammograms or ultrasounds. Several perceived barriers in working with patients and lower physician comfort levels with aspects of BCS were identified. Graduate degree-holding physicians reported higher physician comfort levels, and lower screening and follow-up practice. Increased familiarity with screening guidelines resulted in higher screening and follow-up practice but also higher physician-patient barrier scores. Increased perceived importance in using guidelines correlated to higher screening and follow-up practice scores.Conclusion: The results of this study point to the potential utility and importance in understanding the demographic factors that influence physician beliefs and practices. Results also highlighted the need for evidence-based guidelines for physician education and culturally tailored materials to address communication barriers and physician comfort. Furthermore, when studying physician screening practices and beliefs, context-specific considerations, as well as interprofessional collaboration are essential to improve patient outcomes. Physicians hold a salient role in ensuring that patients have access to cancer screening. Focusing on this group provides a critical focal point in addressing disparities in breast cancer screening and improving outcomes amongst Chinese women.

scholarly journals Examining Breast Cancer Screening Behavior Among Southern Black Women After the 2009 US Preventive Services Task Force Mammography Guideline Revisions

2019 ◽  
Vol 45 (1) ◽  
pp. 20-29 ◽  
Author(s):  
Deeonna E. Farr ◽  
Heather M. Brandt ◽  
Swann Arp Adams ◽  
Venice E. Haynes ◽  
Andrea S. Gibson ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Black Women ◽  
Cancer Screening ◽  
Breast Cancer Screening ◽  
Task Force ◽  
Preventive Services ◽  
Screening Behavior

Using an integrated social-behavioral text message approach to improve screening mammography in African American women.

2020 ◽  
Vol 38 (29_suppl) ◽  
pp. 240-240
Author(s):  
Amina Dhahri ◽  
Paapa Nyanin ◽  
Shana Ntiri
Keyword(s):  
Breast Cancer ◽  
Black Women ◽  
Cancer Screening ◽  
Breast Cancer Screening ◽  
Text Messaging ◽  
Text Message ◽  
Screening Mammography ◽  
Text Messages ◽  
Patient Centered ◽  
Self Advocacy

240 Background: The rate of breast cancer among Black and White women is nearly equivalent but the death rate is 40% higher for Blacks. This disparity is often attributed to lower screening mammography rates in Black women. The effectiveness of text messages on increasing screening mammography among Black women is not well known. Importantly, the themes that are most effective at promoting behavioral changes in Black women’s breast cancer screening practices through text message interventions have not been explored. An integrated social-behavioral approach was used to identify themes associated with Black women’s response to two types of text messaging: reminder and educational texts. Methods: A qualitative study was conducted in Metropolitan Baltimore with two focus groups among Black breast cancer survivors. Participants completed a demographic survey and indicated text messaging practices and preferences for future breast screening texts via survey. Participants provided feedback on a series of 17 educational and reminder text messages. Focus groups were digitally recorded and transcribed for analysis. Text message preferences were analyzed using a content analysis approach. Multiple themes were identified, discussed and recorded. Results: 17 participants had an average age of 60. All participants reported cell phone ownership and 82% of participants reported texting. 46% reported an interest in reminder text messages and 54% reported an interest in educational text messages. Four main themes were derived from participants’ responses the text message series: 1) access to cancer care surveillance, 2) social network support, 3) patient-centered approach, and 4) self-advocacy. Text messages that included themes of self-advocacy, social network support, and patient-centered approach generated positive responses and the text messages that included access to cancer care surveillance were perceived as demotivating. Educational text messages were perceived to be more motivating than reminder text messages. Conclusions: Breast cancer screening behaviors are affected by various demographic, social-behavioral, and socioeconomic factors. The findings from this study suggest that developing an educational text message content that incorporates social and behavioral themes focusing on the patient may be more beneficial to improve breast cancer screening rates in this population.

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