Abstract P2-10-14: Racial differences in no-show rate for screening mammogram
Authors: Whitney L Hensing, Steven Poplack, Cheryl Herman, Foluso O Ademuyiwa
Journal: Cancer Research (2020)

Abstract Background: Screening mammography has been shown to decrease breast cancer mortality, yet adherence to guidelines is far from universal. It has been shown that screening rate are lower in vulnerable populations, such as black women and the uninsured. Increased breast cancer mortality among black women may, in part, be explained by lower screening rates. Prior studies have identified barriers to screening in black women, such as limited access to care, lack of insurance and poor social support. For women who manage to schedule an appointment, and overcome some of these barriers, compliance may still be sub-optimal. The purpose of this case-control study was to determine the no-show rate for scheduled screening mammogram at an urban tertiary care center and determine if racial differences in compliance exist. Methods: Participants were identified from women who scheduled an appointment for screening mammogram at the Joann Knight Breast Imaging Center in Saint Louis, MO between January 2018 and March 2018. Cases were defined as women who did not complete their initial appointment (no-show) and failed to reschedule within six months. Control subjects were defined as women who did complete their appointment and were randomly selected in a 1:1 ratio to cases. Demographic, financial and breast cancer history data was obtained from the electronic medical record. Logistic regression was used to calculate odds-ratios (OR) and 95% confidence intervals (CI). Results: 5,922 appointments for screening mammograms were scheduled during the study period and 1003 (17%) were not completed. A total of 316 women were identified as cases (no-show) and an equal number were randomly selected to serve as controls. Black women were more likely to no-show than non-hispanic white women (OR = 2.64, 95% CI 1.90-3.67). This association was partially explained by several factors, as evidenced by change in the adjusted OR for race greater than 10%. The most notable of these factors were single marital status (adjusted OR for race = 1.87, 95% CI 1.29-2.72), uninsured or Medicaid insurance status (adjusted OR for race = 2.13, 95% CI 1.50-3.026) and residence within five-miles of the imaging center (adjusted OR for race = 2.05, 95% CI 1.43-2.95). Conclusion: We identified a no-show rate of 17% for screening mammograms at our institution. Black women were more likely to no-show than non-hispanic white women. The racial difference in no-show rate was partially explained by marital status, insurance status and distance of residence from the imaging center; suggesting that these factors are significant barriers to compliance with mammogram screening at our institution and these factors identify a particularly vulnerable population of black women. Citation Format: Whitney L Hensing, Steven Poplack, Cheryl Herman, Foluso O Ademuyiwa. Racial differences in no-show rate for screening mammogram [abstract]. In: Proceedings of the 2019 San Antonio Breast Cancer Symposium; 2019 Dec 10-14; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2020;80(4 Suppl):Abstract nr P2-10-14.