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Benefits of Case Management Seen in Breast Cancer Program

Management linked to improved time to diagnosis in low-income women in screening program

FRIDAY, March 19 (HealthDay News) -- Case management for low-income women who receive free breast cancer screening and diagnostic services may reduce their time to diagnosis, according to research published online March 16 in the Archives of Internal Medicine.

Rebecca Lobb, of the Harvard School of Public Health in Boston, and colleagues analyzed data from 2,252 women participating in the National Breast and Cervical Cancer Early Detection Program (BCCEDP) in Massachusetts during 1998 through 2007. Case management became available in 2001 for Massachusetts participants with certain abnormal mammogram findings, and free treatment became available through Medicaid in 2004.

The researchers found that, after case management began, the proportion of women with a diagnostic delay fell from 33 percent to 23 percent, with a significant decrease in the risk of diagnostic delay (relative risk, 0.65). Case management, however, was not linked to changes in treatment delay. The implementation of free treatment was not associated with a difference in risk of diagnostic or treatment delay beyond the improvements seen with case management.

"Our study demonstrated that most women who participated in the Massachusetts BCCEDP received follow-up after an abnormal mammogram within the time recommended by clinical guidelines. Implementation of a case management policy through the Massachusetts BCCEDP was associated with improved time to resolution following an abnormal mammogram, and the benefits of this policy did not differ by race or ethnicity," the authors conclude.

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