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Mammography Use and Physician Recommendation After the 2009 U.S. Preventive Services Task Force Breast Cancer Screening Recommendations

Published:December 14, 2015DOI:https://doi.org/10.1016/j.amepre.2015.10.010

      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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