Mammography rates after the 2009 revision to the United States Preventive Services Task Force breast cancer screening recommendation

Abstract

Background In 2009, the United States Preventive Services Task Force (USPSTF) recommended against routine mammography screening for women aged 40–49 years. This revised recommendation was widely criticized and has sparked off intense debate. The objectives of this study are to examine the impact of the revised recommendation on the proportion of women receiving mammograms and how the effect varied by age. Methods We identified women who had continuous health insurance coverage and who did not have breast cancer between 2008 and 2011 in the Truven Health MarketScan Commercial Claims Databases using mammogram procedure codes. Using women aged 50–59 years as a control group, we used a differences-in-differences approach to estimate the impact of the revised recommendation on the proportion of women ages 40–49 years who received at least one mammogram. We also compared the age-specific changes in the proportion of women ages 35–59 years who were screened before and after the release of the revised recommendation. Results The proportion of women screened among the 40–49 and 50–59 age groups were 58.5 and 62.5%, respectively, between 2008 and 2009, and 56.9 and 62.0%, respectively, between 2010 and 2011. After 2009, the proportion of women screened declined by 1.2 percentage point among women aged 40–49 years (P < 0.01). The proportion of women screened decreased for all ages, and decreases were larger among women closer to the 40-year threshold. Conclusions The 2009 USPSTF breast cancer recommendation was followed by a small reduction in the proportion of insured women aged 40–49 years who were screened. Reductions were larger among women at the younger end of the age range, who presumably had less prior experience with mammography than women nearing 50.

The Effect of the 2009 USPSTF breast cancer screening recommendations on breast cancer in Michigan: A longitudinal study

“…A review of screening mammography utilization by Sharpe et al in the Medicare population noted a decrease in 4.3% in 2010 in this older population after seeing annual growth of 0.5% prior to the 2009 recommendations. In contrast, using claims data, a smaller decrease in screening mammography use of 1.2% was identified in a cohort of insured women under the age of 50 years . In our MiBOQI cohort of women under 50 years, no compensatory increase in palpable tumors was noted after the 2009 recommendations, but rather the rate remained relatively stable.…”

“…The association between other factors, including race, tumor grade, and histology, and method of detection of the tumor did not differ between the age groups. Univariate analysis of associations between demographic and clinicopathologic characteristics and patient age at time of breast cancer diagnosis age of 50 years 12. In our MiBOQI cohort of women under 50 years, no compensatory increase in palpable tumors was noted after the 2009 recommendations, but rather the rate remained relatively stable.…”

The Survey on Women’s Health in China

“…It was especially higher among the women aged 40-50 (92.9%) and 50-60 (90.5%) years old in Beijing. The percentage of women screened among the 40-49 and 50-59 age groups were 58.5 and 62.5%, respectively, between 2008 and 2009, and 56.9 and 62.0%, respectively, between 2010 and 2011 in the united states [9]. The total proportion was 67% in American women older than 40 who had a mammogram in another study [10].…”

Racial and Ethnic Differences in Breast Cancer Patients: A Study for Michigan and California

“…Emphasis on earlier mammography screening was reinforced with the 2016 legislature from the Affordable Care Act (ACA) that ensures most all insurance companies fully cover mammograms in women age 40 and over with no cost sharing [17]. A recent study examined the effects of the USPSTF public announcement on screening rates for breast cancer, of which a small reduction was found [18]. Similar methods could be used as tools for the future to increase awareness and screening rates in high-risk populations, and indirectly improve survival times in women of all races and ethnicities [18].…”

“…A recent study examined the effects of the USPSTF public announcement on screening rates for breast cancer, of which a small reduction was found [18]. Similar methods could be used as tools for the future to increase awareness and screening rates in high-risk populations, and indirectly improve survival times in women of all races and ethnicities [18]. Extensive study in the differences between survival of breast cancer patients among various states and ethnicities can be found in the works of Khan, et al [19][20][21][22].…”