REFERRAL ADHERENCE IN AN INNER-CITY BREAST AND CERVICAL-CANCER SCREENING-PROGRAM

Background. Early detection and immediate follow-up treatment for canc er of the breast and cervix can reduce morbidity and mortality. This r eport describes adherence to follow-up appointments for suspected brea st and cervical malignancies in a population of low-income black women who participated in a community-based nurse-managed screening program . Methods. Components of the program that were part of the interventio n included the following: a consistent referral mechanism augmented by a computerized tickler system; education of women about the importanc e of follow-up; and active nurse assistance in the follow-up process. Referral for follow-up of suspected malignancies or for other question able findings was made to the public sector hospital clinics (86%) or to other providers of the women's choice (14%). Results. Follow-up rat es for suspected malignancies of the breast were high (92%) in this po pulation of women, sometimes described as less likely to adhere to rec ommendations for continued care. In contrast, adherence rates for gyne cologic conditions were lower (70%). Conclusions. This screening progr am and follow-up system has relevance to systems that serve similar gr oups of low-income women.