Date of Award

January 2016

Document Type

Thesis

Degree Name

Master of Public Health (MPH)

Department

School of Public Health

First Advisor

Beth Jones

Abstract

Abstract

Background: Breast cancer is the most common cause of cancer death among Hispanic/Latino patients. Similar to non-Hispanic Black women, Hispanic/Latino women are more likely to be diagnosed with later stage breast cancer and experience worse survival rates when compared to non-Hispanic White women. This study was focused on identifying predictors of inadequate follow-up of abnormal screening mammograms in this culturally diverse Hispanic/Latina population.

Methods: We studied 189 subjects with abnormal or inconclusive mammograms identified from a prospective cohort of Hispanic/Latino women (n=1570), aged 40-75, living in Connecticut and followed their cancer screening experience over a 2-4 year period. Using multivariate logistic regression, we identified independent predictors of inadequate follow-up of an abnormal mammogram.

Results: Over 31% of women requiring immediate or short-term follow-up did not receive this care within three months of the recommended return date. Patient body mass index, age, pain experienced during the mammogram, and a subject’s perceived control over health outcomes were significant independent predictors of inadequate follow-up. Self-rated health was initially identified as a significant predictor, but was explained through stratification by patient comorbidities.

Conclusion: While inadequate follow-up of abnormal mammograms undermines the potential benefits of mammography screening for all women, the observed differences in this study may have implications for the persistent ethnic differences in breast cancer stage at diagnosis and survival. With few published studies that address cancer screening on Hispanic/Latinas residing in the Northeastern, US, more research is needed to identify factors that contribute to poor follow-up following cancer screening tests in this population of women who are at risk for relatively poor outcomes of breast cancer.

Comments

This thesis is restricted to Yale network users only. It will be made publicly available on 01/04/2018

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