Follow-up after an abnormal screening mammogram: Impact of a pandemic on mobile mammography patients.

OBJECTIVES

To evaluate the effect of COVID-19 on a mobile screening mammography program as measured by turnaround time (TAT) in days between an abnormal screening mammogram (sMG) and diagnostic mammography.

MATERIAL AND

METHODS

All of our institution's sMG (mobile and non-mobile) from January 2017, to December 2022 were retrospectively reviewed, and those dated March 7, 2020-July 7, 2020 were excluded because our mobile sMG program was non-operative at that time due to COVID-19. TATs and patient demographics were compared for mobile and non-mobile sMG patients between 2 time periods: Pre-pandemic (January 1, 2017-March 6, 2020) and pandemic (July 8, 2020-December 31, 2022). Statistics included multiple linear regression analysis, Fisher's Exact, and Wilcoxon Rank Sum tests.

RESULTS

During the pre-pandemic period, 11,439 female patients (9309 without insurance, 81.3%) underwent 14,161 mobile sMG, while 28,737 female patients (429 without insurance, 1.5%) underwent 57,840 non-mobile sMG. During the pandemic period, 6805 female patients (6720 without insurance, 98.8%) underwent 7663 mobile sMG, while 32,655 female patients (868 without insurance, 2.7%) underwent 53,540 non-mobile sMG. Median TATs for mobile uninsured patients increased from 41 days during the pre-pandemic period to 51 days during the pandemic period (p < 0.001), while median TATs for non-mobile insured patients decreased from 20 days during the pre-pandemic period to 14 days during the pandemic period (p < 0.001). Increased TATs were associated with Asian, African American, and Other race compared with White race (Asian, p = 0.004; African American, p < 0.001; and Other, p = 0.02) and self-pay insurance status (p = 0.006).

CONCLUSION

For mobile uninsured screening patients, the number of days between screening and diagnostic mammography increased with the COVID-19 pandemic, while it decreased for non-mobile insured screening patients. Mobile uninsured mammography patients may represent a population that needs additional attention. These findings highlight a health equity concern, as the pandemic disproportionately widened disparities in timely follow-up care for uninsured patients served by mobile mammography programs.