Poor compliance despite equal access: Military experience with screening breast MRI in high risk women - 16/04/19
, Jessica B. Weiss a , Helen F. McGregor b , Dominic M. Forte a , Rowan R. Sheldon a , Vance Y. Sohn a Abstract |
Background |
Using the military as a model for an equal-access, no-cost healthcare system, we sought to (1) describe screening breast MRI compliance rates and (2) identify patient-perceived barriers to screening.
Methods |
In this retrospective cohort study of a prospectively maintained database at a tertiary level center, we compared compliance among women at ≥20% risk of developing breast cancer (Tyrer-Cuzick) and conducted structured phone interviews with women at ≥30% risk.
Results |
From 2015 to 2016, 1,052 women met criteria for screening MRI. Of these, only 251 (24%) underwent MRI screening. Compliance among women with a 20–24%, 25–29%, 30–39%, and ≥40% risk was 16%, 24%, 37%, and 51%, respectively (p < 0.02). 37 of 128 unique patients (29%) with ≥30% risk agreed to interview. 43% cited time/inconvenience as the key barrier to screening; 22% cited questions regarding screening recommendations; and only 3% cited fear/concerns as the key barrier.
Conclusions |
Even in an equal-access system, there is poor compliance in patients who are at high risk for developing breast cancer. Patients cited time/inconvenience and questions regarding screening as key barriers to screening.
Le texte complet de cet article est disponible en PDF.Highlights |
• | Poor compliance with screening breast MRI in military's equal-access, no-cost healthcare system. |
• | Even a ≥40% lifetime risk did not ensure uniform adherence to screening. |
• | Patients perceive time/inconvenience and questions regarding screening as key barriers. |
Keywords : Cancer screening, Breast MRI, Healthcare access
Plan
Vol 217 - N° 5
P. 843-847 - mai 2019 Retour au numéro
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