Introduction
In 2009, the U.S. Preventive Services Task Force (USPSTF) no longer recommended routine
mammography for women aged 40–49 and ≥75 years (younger and older women, respectively).
Whether mammography usage and physician recommendation among younger and older women
changed in response to these recommendations is unclear.
Methods
Cross-sectional data from women aged ≥40 years in the 2008 and 2013 National Health
Interview Surveys were used (n=4,942 younger and 3,047 older women) and were analyzed in 2015. Changes between 2008
and 2013 in self-reports about having undergone mammography in the past 2 years and
physician recommendation for mammography were expressed as adjusted prevalence difference
(PD) and 95% CI.
Results
Overall, adjusted prevalence of mammography among younger women was similar in 2008
(62.2%) and 2013 (58.5%) (p=0.05), but significantly declined in high-income (PD=–6.1%, 95% CI=–11.2, –1.0);
non-Hispanic white (PD=–5.5%, 95% CI=–10.2, –0.8); and privately insured (PD=–5.7%,
95% CI=–9.8, –1.6) younger women. For older women, there was no change in adjusted
mammography prevalence overall (2008, 56.2%; 2013, 54.2%; p=0.473) or by SES. Physician mammography recommendation declined in younger (PD=–5.0%,
95% CI=–8.7, –1.3) and older (PD=–5.8%, 95% CI=–10.5, –1.1) women.
Conclusions
Four years after publication of USPSTF mammography recommendations, mammography prevalence
for younger and older women did not significantly decrease except for higher-SES younger
women. The significant decrease in physician recommendation of mammography in younger
and older women may reflect a change in practice patterns by some physicians in response
to USPSTF recommendations.
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Article Info
Publication History
Published online: December 14, 2015
Identification
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© 2016 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.
