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Canadian Journal of Public Health = Revue Canadienne de Santé Publique logoLink to Canadian Journal of Public Health = Revue Canadienne de Santé Publique
. 2008 Jul 1;99(4):252–256. doi: 10.1007/BF03403749

Facilitated “Fast Track” Referral Reduces Time from Abnormal Screening Mammogram to Diagnosis

Marilyn J Borugian 13,23,✉, Lisa Kan 13, Christina C Y Chu 13, Kathy Ceballos 33, Karen A Gelmon 43, Paula B Gordon 13, Barbara Poole 53, Scott Tyldesley 63, Ivo A Olivotto 63
PMCID: PMC6976254  PMID: 18767265

Abstract

Background

The Screening Mammography Program of British Columbia (SMPBC) implemented voluntary, facilitated referral to diagnostic imaging (“Fast Track”) after testing 5 interventions to reduce time from an abnormal screening mammogram to diagnosis. The purpose of this study was to compare time intervals for patients evaluated through the Fast Track process with patients who were not.

Methods

Data were extracted from the SMPBC database for women with abnormal screens conducted from January 1, 2003 to June 30, 2005 (N=40,292). After exclusions, 39,607 screens were analyzed. Median and 90th percentile times were calculated from abnormal screen to diagnosis and for three subintervals: abnormal screen to notification, notification to first assessment, and first assessment to diagnosis.

Results

One third of abnormal screens were investigated through Fast Track imaging facilities. Overall, the median time from abnormal screen to diagnosis was 8 days faster for Fast Track compared with non-Fast Track. There was no clinically significant difference in time from abnormal screen to notification. The median time from notification to first assessment was 1.1 weeks (Fast Track) compared with 2.4 weeks (non-Fast Track), a reduction of 9 days or 54% in the interval targeted by the Fast Track strategy. The time interval distribution from first assessment to diagnosis was significantly different only for those having a core biopsy (average 3 days faster for Fast Track).

Interpretation

Facilitated referral to diagnostic imaging reduces average time from notification of abnormal screen to first assessment by more than half. Additional strategies are needed to address diagnostic investigation beyond initial imaging procedures.

Key words: Mammography; breast neoplasms; diagnostic techniques and procedures; waiting lists; mass screening

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