Delayed or failure to follow-up abnormal breast cancer screening mammograms in primary care: a systematic review
Open Access
- 7 April 2021
- journal article
- review article
- Published by Springer Science and Business Media LLC in BMC Cancer
- Vol. 21 (1), 1-14
- https://doi.org/10.1186/s12885-021-08100-3
Abstract
Successful breast cancer screening relies on timely follow-up of abnormal mammograms. Delayed or failure to follow-up abnormal mammograms undermines the potential benefits of screening and is associated with poorer outcomes. However, a comprehensive review of inadequate follow-up of abnormal mammograms in primary care has not previously been reported in the literature. This review could identify modifiable factors that influence follow-up, which if addressed, may lead to improved follow-up and patient outcomes. A systematic literature review to determine the extent of inadequate follow-up of abnormal screening mammograms in primary care and identify factors impacting on follow-up was conducted. Relevant studies published between 1 January, 1990 and 29 October, 2020 were identified by searching MEDLINE®, Embase, CINAHL® and Cochrane Library, including reference and citation checking. Joanna Briggs Institute Critical Appraisal Checklists were used to assess the risk of bias of included studies according to study design. Eighteen publications reporting on 17 studies met inclusion criteria; 16 quantitative and two qualitative studies. All studies were conducted in the United States, except one study from the Netherlands. Failure to follow-up abnormal screening mammograms within 3 and at 6 months ranged from 7.2–33% and 27.3–71.6%, respectively. Women of ethnic minority and lower education attainment were more likely to have inadequate follow-up. Factors influencing follow-up included physician-patient miscommunication, information overload created by automated alerts, the absence of adequate retrieval systems to access patient’s results and a lack of coordination of patient records. Logistical barriers to follow-up included inconvenient clinic hours and inconsistent primary care providers. Patient navigation and case management with increased patient education and counselling by physicians was demonstrated to improve follow-up. Follow-up of abnormal mammograms in primary care is suboptimal. However, interventions addressing amendable factors that negatively impact on follow-up have the potential to improve follow-up, especially for populations of women at risk of inadequate follow-up.Keywords
This publication has 77 references indexed in Scilit:
- Patient Navigation and Time to Diagnostic Resolution: Results for a Cluster Randomized Trial Evaluating the Efficacy of Patient Navigation among Patients with Breast Cancer Screening Abnormalities, Tampa, FLPLOS ONE, 2013
- Understanding the management of electronic test result notifications in the outpatient settingBMC Medical Informatics and Decision Making, 2011
- Peer navigation improves diagnostic follow-up after breast cancer screening among Korean American women: results of a randomized trialCancer Causes & Control, 2010
- Barriers to Follow-Up of an Abnormal Pap Smear in Latina Women Referred for ColposcopyJournal of General Internal Medicine, 2010
- Systematic Review: Comparative Effectiveness of Core-Needle and Open Surgical Biopsy to Diagnose Breast LesionsAnnals of Internal Medicine, 2010
- Risk factors for delayed presentation and referral of symptomatic cancer: evidence for common cancersBritish Journal of Cancer, 2009
- Follow-up of abnormal screening mammograms among low-income ethnically diverse women: Findings from a qualitative studyPatient Education and Counseling, 2008
- The Effect of Patient Navigation on Time to Diagnosis, Anxiety, and Satisfaction in Urban Minority Women with Abnormal Mammograms: A Randomized Controlled TrialJournal of Urban Health, 2007
- Communication Outcomes of Critical Imaging Results in a Computerized Notification SystemJournal of the American Medical Informatics Association, 2007