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Breast cancer screening in an urban public hospital. Five-year results
J Bressler1, D Ansell, J Parker
1Department of Medicine, Cook County Hospital, Chicago, IL 60612.
Background:
This report describes the first 5 years of the Breast Cancer Screening Program (BCSP) at Cook County Hospital (CCH), a hospital that serves a predominantly African-American and low-income population.
Methods:
A retrospective review of hospital cancer registry staging for breast cancers diagnosed between 1984 and 1988 was performed.
Results:
Between 1984 and 1988, 499 new breast cancers were diagnosed at CCH, of which 33% were diagnosed after referral from the BCSP. The percentage of early breast cancers, defined as Stages 0 or 1, was 25% in women referred from the BCSP, compared with 6% for women referred from other clinical areas (P < 0.001). During this same period of time, the proportion of women at CCH with localized breast cancer increased from 30% in 1980-1983 to 40% from 1984-1988 (P < 0.05), an increase that can be attributed to the BCSP. Only 21% of the breast cancers detected by the BCSP were found by mammography alone. Of these, 91% were localized.
Conclusions:
The BCSP has had an impact on the proportion of early breast cancer diagnosed at CCH. Despite these efforts, the proportion of early breast cancer diagnosed at CCH (12%) is significantly less than that seen for all African-American women with breast cancer in Illinois (32%; P < 0.001).