Display options
Share it on

Cancer. 2021 Jun 01;127(11):1857-1863. doi: 10.1002/cncr.33435. Epub 2021 Apr 01.

Racial differences in no-show rates for screening mammography.

Cancer

Whitney L Hensing, Steven P Poplack, Cheryl R Herman, Siobhan Sutcliffe, Graham A Colditz, Foluso O Ademuyiwa

Affiliations

  1. Division of Oncology, Department of Medicine, Washington University School of Medicine, St. Louis, Missouri.
  2. Breast Imaging Section, Department of Radiology, Washington University School of Medicine, St. Louis, Missouri.
  3. Division of Public Health Sciences, Department of Surgery, Washington University School of Medicine, St. Louis, Missouri.

PMID: 33792894 DOI: 10.1002/cncr.33435

Abstract

BACKGROUND: Differences in utilization of screening mammography partly explain the increased breast cancer mortality observed in African American (AA) women compared with non-Hispanic White women. However, the contribution of noncompliance from women who do not come for their scheduled screening mammography appointment (ie, no-shows) is unknown. The purpose of this study was to investigate racial differences in no-show rates for screening mammography.

METHODS: Women scheduled for routine screening mammograms between January 2018 and March 2018 were identified from the Joanne Knight Breast Health Center at Siteman Cancer Center in St. Louis, Missouri. Using a case-control design, this study retrospectively identified patients who no-showed for their mammograms (cases) and randomly sampled an equal number of patients who completed their mammograms (controls). These participants were compared by race. The main outcome measure was whether AA race was associated with no-shows for screening mammography.

RESULTS: During the study period, 5060 women were scheduled for screening mammography, and 316 (6.2%) did not keep their appointment (ie, they no-showed). Women who no-showed were more likely to be AA than women who kept their appointment (odds ratio, 2.64; 95% confidence interval, 1.90-3.67). Even after adjustments for marital status, insurance type, and place of residence, AA race was still significantly associated with no-shows for screening mammography.

CONCLUSIONS: This study identified a no-show rate of 6.2% for screening mammography at the authors' institution. Women who no-showed were more likely to be AA than women who completed their mammogram even after adjustments for multiple factors. These data can be leveraged for future studies aimed at improving mammography attendance rates among AA women.

© 2021 American Cancer Society.

Keywords: African American; breast cancer; disparities; no-show; screening mammography

References

  1. Henley SJ, Ward EM, Scott S, et al. Annual report to the nation on the status of cancer, part I: national cancer statistics. Cancer. 2020;126:2225-2249. - PubMed
  2. Siegel RL, Miller KD, Jemal A. Cancer statistics, 2020. CA Cancer J Clin. 2020;70:7-30. - PubMed
  3. Screening mammography: a missed clinical opportunity? Results of the NCI Breast Cancer Screening Consortium and National Health Interview Survey Studies. JAMA. 1990;264:54-58. - PubMed
  4. Pace LE, He Y, Keating NL. Trends in mammography screening rates after publication of the 2009 US Preventive Services Task Force recommendations. Cancer. 2013;119:2518-2523. - PubMed
  5. Li L, Ji J, Besculides M, et al. Factors associated with mammography use: a side-by-side comparison of results from two national surveys. Cancer Med. 2020;9:6430-6451. - PubMed
  6. Ahmed AT, Welch BT, Brinjikji W, et al. Racial disparities in screening mammography in the United States: a systematic review and meta-analysis. J Am Coll Radiol. 2017;14:157-165.e9. - PubMed
  7. Smigal C, Jemal A, Ward E, et al. Trends in breast cancer by race and ethnicity: update 2006. CA Cancer J Clin. 2006;56:168-183. - PubMed
  8. Lantz PM, Mujahid M, Schwartz K, et al. The influence of race, ethnicity, and individual socioeconomic factors on breast cancer stage at diagnosis. Am J Public Health. 2006;96:2173-2178. - PubMed
  9. Carey LA, Perou CM, Livasy CA, et al. Race, breast cancer subtypes, and survival in the Carolina Breast Cancer Study. JAMA. 2006;295:2492-2502. - PubMed
  10. Shavers VL, Harlan LC, Stevens JL. Racial/ethnic variation in clinical presentation, treatment, and survival among breast cancer patients under age 35. Cancer. 2003;97:134-147. - PubMed
  11. Ademuyiwa FO, Gao F, Hao L, et al. US breast cancer mortality trends in young women according to race. Cancer. 2015;121:1469-1476. - PubMed
  12. Smith-Bindman R, Miglioretti DL, Lurie N, et al. Does utilization of screening mammography explain racial and ethnic differences in breast cancer? Ann Intern Med. 2006;144:541-553. - PubMed
  13. Curtis E, Quale C, Haggstrom D, Smith-Bindman R. Racial and ethnic differences in breast cancer survival: how much is explained by screening, tumor severity, biology, treatment, comorbidities, and demographics? Cancer. 2008;112:171-180. - PubMed
  14. Johnson BJ, Mold JW, Pontious JM. Reduction and management of no-shows by family medicine residency practice exemplars. Ann Fam Med. 2007;5:534-539. - PubMed
  15. Barron WM. Failed appointments. Who misses them, why they are missed, and what can be done. Prim Care. 1980;7:563-574. - PubMed
  16. Curran JS, Halpert RD, Straatman A. Patient “no-shows”-a costly problem. Radiol Manage. 1989;11:20-23. - PubMed
  17. Sheridan R, Oliver SE, Hall G, et al. Patient non-attendance at urgent referral appointments for suspected cancer and its links to cancer diagnosis and one year mortality: a cohort study of patients referred on the Two Week Wait pathway. Cancer Epidemiol. 2019;63:101588. - PubMed
  18. Chang JT, Sewell JL, Day LW. Prevalence and predictors of patient no-shows to outpatient endoscopic procedures scheduled with anesthesia. BMC Gastroenterol. 2015;15:123. - PubMed
  19. Childers RE, Laird A, Newman L, Keyashian K. The role of a nurse telephone call to prevent no-shows in endoscopy. Gastrointest Endosc. 2016;84:1010-1017.e1. - PubMed
  20. Lagarde SP. No one left behind: the road to 80% by 2018. Clin Gastroenterol Hepatol. 2014;12:1212-1215. - PubMed
  21. Reid MW, Cohen S, Wang H, et al. Preventing patient absenteeism: validation of a predictive overbooking model. Am J Manag Care. 2015;21:902-910. - PubMed
  22. Harvey HB, Liu C, Ai J, et al. Predicting no-shows in radiology using regression modeling of data available in the electronic medical record. J Am Coll Radiol. 2017;14:1303-1309. - PubMed
  23. Rosenbaum JI, Mieloszyk RJ, Hall CS, Hippe DS, Gunn ML, Bhargava P. Understanding why patients no-show: observations of 2.9 million outpatient imaging visits over 16 years. J Am Coll Radiol. 2018;15:944-950. - PubMed
  24. Margolis KL, Lurie N, McGovern PG, Slater JS. Predictors of failure to attend scheduled mammography appointments at a public teaching hospital. J Gen Intern Med. 1993;8:602-605. - PubMed
  25. US Census Bureau.QuickFacts. Accessed July 28, 2020. https://www.census.gov/quickfacts/fact/table/US/PST045219 - PubMed
  26. Drabkin MJ, Lobel S, Kanth N, et al. Telephone reminders reduce no-shows: a quality initiative at a breast imaging center. Clin Imaging. 2019;54:108-111. - PubMed
  27. Mehta SJ, Jensen CD, Quinn VP, et al. Race/ethnicity and adoption of a population health management approach to colorectal cancer screening in a community-based healthcare system. J Gen Intern Med. 2016;31:1323-1330. - PubMed
  28. Laiyemo AO, Doubeni C, Pinsky PF, et al. Race and colorectal cancer disparities: health-care utilization vs different cancer susceptibilities. J Natl Cancer Inst. 2010;102:538-546. - PubMed
  29. Johnson NL, Head KJ, Scott SF, Zimet GD. Persistent disparities in cervical cancer screening uptake: knowledge and sociodemographic determinants of Papanicolaou and human papillomavirus testing among women in the United States. Public Health Rep. 2020;135:483-491. - PubMed
  30. Luckett R, Pena N, Vitonis A, Bernstein MR, Feldman S. Effect of patient navigator program on no-show rates at an academic referral colposcopy clinic. J Womens Health (Larchmt). 2015;24:608-615. - PubMed
  31. Mugavero MJ, Lin HY, Allison JJ, et al. Racial disparities in HIV virologic failure: do missed visits matter? J Acquir Immune Defic Syndr. 2009;50:100-108. - PubMed
  32. Shimotsu S, Roehrl A, McCarty M, et al. Increased likelihood of missed appointments (“no shows”) for racial/ethnic minorities in a safety net health system. J Prim Care Community Health. 2016;7:38-34. - PubMed
  33. Vang S, Margolies LR, Jandorf L. Mobile mammography participation among medically underserved women: a systematic review. Prev Chronic Dis. 2018;15:E140. - PubMed
  34. Sheppard VB, Huei-Yu Wang J, Eng-Wong J, Martin SH, Hurtado-de-Mendoza A, Luta G. Promoting mammography adherence in underserved women: the telephone coaching adherence study. Contemp Clin Trials. 2013;35:35-42. - PubMed
  35. Earp JA, Eng E, O’Malley MS, et al. Increasing use of mammography among older, rural African American women: results from a community trial. Am J Public Health. 2002;92:646-654. - PubMed
  36. Battaglia TA, Roloff K, Posner MA, Freund KM. Improving follow-up to abnormal breast cancer screening in an urban population. Cancer. 2007;109:359-367. - PubMed
  37. Margolis KL, Lurie N, McGovern PG, Tyrrell M, Slater JS. Increasing breast and cervical cancer screening in low-income women. J Gen Intern Med. 1998;13:515-521. - PubMed

Publication Types

Grant support