Mammography Screening Delays in Metro-Atlanta by Race (White/Black), Age, Socioeconomic Status, Insurance, and Distance to Facility Public
Reddy, Arthi (Spring 2020)
Published
Abstract
Breast cancer survival prognosis is heavily influenced by early detection through mammography screening. In 2019, there were an estimated 268,600 newly diagnosed cases of invasive breast cancer, which represents 15.2% of all new cancer cases, along with 62,930 new cases of non-invasive (in situ) breast cancer. Since the advent of mammography screening, 5-year relative survival rates have improved to 99% for localized cancer, 86% for regional cancer, and 27% for distant cancer. However, mammogram screening delays in diagnosis can prevent the early detection of breast cancer. Using data from six hospitals in the metro-Atlanta region within the state of Georgia, we aimed to understand what factors (e.g., race, age, socio-economic status [SES], insurance, distance) associate with delays in screening among non-Hispanic White (NHW) and non-Hispanic Black (NHB) ultimately diagnosed with breast cancer between 2010-2014 (n=806). Results showed that NHB women were more likely to face delays in diagnosis compared to NHW women and SES-related factors were associated with diagnostic delays. The number of days in delays were, overall, more than those reported for the US populations and our findings are different from those of equal-access institutions that showed no such racial differences. We hypothesize that African-American race is a surrogate to SES factors and further research is needed to suggest remedial measures to overcome these racial differences.
Table of Contents
Table of Contents
Background
Methods
Results
Discussion
Tables
Table 1. Demographic characteristics by screening delay characteristics (average BX Days, DX Days, and LOC Days) among 806 women who underwent breast cancer screening prior to a breast cancer diagnosis in the metropolitan Atlanta area (2010-2014).
Table 2. Association between patient demographic characteristics and average screening delay among 806 white and black women diagnosed with breast cancer in Atlanta (2010-2014) using quantile regression at the 50% quantile multi-variable adjusted and age-adjusted
Table 3. Association between patient demographic characteristics and average screening delay among 806 white and black women diagnosed with breast cancer in Atlanta (2010-2014) multi-variable adjusted and age adjusted.
Figures and Figure Legends
Figure 1. Directed Acyclic Graph Demonstrating the Effect of Race on Delay
Figure 2. Directed Acyclic Graph Demonstrating the Effect of Age on Delay
Figure 3. Directed Acyclic Graph Demonstrating the Effect of Insurance on Delay
Figure 4. Directed Acyclic Graph Demonstrating the Effect of Distance on Delay
Figure 5. Directed Acyclic Graph Demonstrating the Effect of SES on Delay
Appendix
Supplemental Table 1: Demographic characteristics by screening delay characteristics (average BX Days, DX Days, and LOC Days) among 806 women who underwent breast cancer screening prior to a breast cancer diagnosis in the metropolitan Atlanta area (2010-2014).
Supplemental Table 2: Association between patient demographic characteristics and average screening delay among 806 white and black women diagnosed with breast cancer in Atlanta (2010-2014) multi-variable and age adjusted.
References
About this Master's Thesis
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