RT Journal Article SR Electronic T1 Insurance-Based Differences in Time to Diagnostic Follow-up after Positive Screening Mammography JF Cancer Epidemiology Biomarkers & Prevention JO Cancer Epidemiol Biomarkers Prev FD American Association for Cancer Research SP 1474 OP 1482 DO 10.1158/1055-9965.EPI-16-0148 VO 25 IS 11 A1 Durham, Danielle D. A1 Robinson, Whitney R. A1 Lee, Sheila S. A1 Wheeler, Stephanie B. A1 Reeder-Hayes, Katherine E. A1 Bowling, J. Michael A1 Olshan, Andrew F. A1 Henderson, Louise M. YR 2016 UL http://cebp.aacrjournals.org/content/25/11/1474.abstract AB Background: Insurance may lengthen or inhibit time to follow-up after positive screening mammography. We assessed the association between insurance status and time to initial diagnostic follow-up after a positive screening mammogram.Methods: Using 1995–2010 data from a North Carolina population-based registry of breast imaging and cancer outcomes, we identified women with a positive screening mammogram. We compared receipt of follow-up within 60 days of screening using logistic regression and evaluated time to follow-up initiation using Cox proportional hazards regression.Results: Among 43,026 women included in the study, 73% were <65 years and 27% were 65+ years. Median time until initial diagnostic follow-up was similar by age group and insurance status. In the adjusted model for women <65, uninsured women experienced a longer time to initiation of diagnostic follow-up [HR, 0.47; 95% confidence interval (CI), 0.25–0.89] versus women with private insurance. There were increased odds of these uninsured women not meeting the Centers for Disease Control and Prevention guideline for follow-up within 60 days (OR, 1.59; 95% CI, 1.31–1.94). Among women ages 65+, women with private insurance experienced a faster time to follow-up (adjusted HR, 2.09; 95% CI, 1.27–3.44) than women with Medicare and private insurance. Approximately 10% of women had no follow-up by 365 days.Conclusions: We found differences in time to initial diagnostic follow-up after a positive screening mammogram by insurance status and age group. Uninsured women younger than 65 years at a positive screening event had delayed follow-up.Impact: Replication of these findings and examination of their clinical significance warrant additional investigation. Cancer Epidemiol Biomarkers Prev; 25(11); 1474–82. ©2016 AACR.This article is featured in Highlights of This Issue, p. 1447