Screening Intervention Improves Access to Mammograms

December 05, 2018

Access to quality breast cancer screening and treatment may contribute to racial disparities outcomes. In 2016, researchers at the urban safety net Cook County Health and Hospitals System in Chicago, IL, implemented changes in mammography practices, which included installing digital machines at one of four sites, centralizing reading of images at a single site with radiologists specialized in mammography, and increasing care coordination such as enhanced patient outreach efforts. The efforts improved screening volume and cancer detection, according to the results presented at the San Antonio Breast Cancer Symposium on December 5, 2018 (

Researchers collected data from 15,918 screening mammograms performed at four Cook County Health and Hospitals System centers and analyzed outcomes six months prior to and one year after implementing the changes.

The volume of screening mammograms completed at each site increased by a range of 61%–322% between six months prior to and six months after the intervention. The increase in volume was sustained at one year postintervention, but the gains were smaller, ranging from 12%–70%.

The proportion of women with timely follow-up after abnormal mammogram also improved across all sites. Follow-up imaging increased from 38% preintervention to 68% postintervention. The percentage of women undergoing a biopsy within 60 days increased from 62% to 75%.

Cancer detection rates improved at two of the sites with the lowest preintervention values, from 1.7 to 3.1 per 1,000 mammograms and 2.8 to 5.7 per 1,000 mammograms.

The improvements “may translate to better outcomes for all women,” the researchers noted.

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