Women with abnormal screening mammography lost to follow-up An experience from Taiwan
Journal
Medicine (United States)
Journal Volume
95
Journal Issue
24
Pages
e3889
Date Issued
2016
Author(s)
Abstract
Breast cancer has the highest incidence among all cancers for women in Taiwan. The current screening policy in Taiwan suggested a biennialmammography for allwomen 40 to 69 years of age.A recommendation for additional testing is recommended forwomen with a BI-RADS result of 0 or 4; a request made via postal mail. Approximately 20% of high-risk patients do not receive additional follow-up. Therefore, we aimed to explore the causes of these patients being lost to follow-up, despite an abnormal mammogram. Two questionnaires were designed separately according to the conceptual framework of the Health BeliefModel. Study participants, women whoreceived a screeningmammography at the National TaiwanUniversity Hospital in 2011 with a BI-RADof 0 or 4,were interviewed via telephone. The dependent variable was receipt of follow-up or not. The analyses were performed by using χ2 tests and logistic regressionmodels. In total, 528 women were enrolled in the study: 51.2%in BI-RADS0 group and 56.6%in BI-RADS4, respectively. In the BI-RADS 0 group, those patients who received a follow-up examination cited the most likely causes to be physician suggestion, health implications, and concerns regarding breast cancer. Patients who did not receive a follow-up examination cited a lack of time and a perception of good personal health as primary reasons. In the BI-RADS 4 group, those patients who received a follow-up examination cited the physician's recommendation and a recognition of the importance of follow-up examinations. Patients who did not receive a follow-up examination cited having received follow-up at another hospital and a desire for a second opinion. In the BI-RADS 0 group, multivariate analysis showed that patients with higher scores in the "perceived benefits" domain were statisticallymore likely to receive a follow-up examination. There was no significant difference in perceived threats, perceived barriers, action cues, or self-efficacy between groups. We conclude that additional education to raise breast cancer awareness in the general public and healthcare providers will be needed to improve the rate of follow-up examinations after an abnormal screening mammogram. ? 2016 Wolters Kluwer Health, Inc. All rights reserved.
Other Subjects
adult; Article; association; awareness; breast cancer; conceptual framework; female; follow up; Health Belief Model; health education; high risk patient; human; major clinical study; mammography; perception; priority journal; questionnaire; self concept; Taiwan; telephone interview; aged; Breast Neoplasms; early cancer diagnosis; incidence; mammography; mass screening; middle aged; procedures; retrospective study; Adult; Aged; Breast Neoplasms; Early Detection of Cancer; Female; Humans; Incidence; Lost to Follow-Up; Mammography; Mass Screening; Middle Aged; Retrospective Studies; Surveys and Questionnaires; Taiwan
Publisher
Lippincott Williams and Wilkins
Type
journal article