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Cancer Causes Control (2017) 28:4148
DOI 10.1007/s10552-016-0835-1
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Mammography rates after the 2009 revision to the United States Preventive Services Task Force breast cancer screening recommendation
Xuanzi Qin1 Florence K.L. Tangka2 Gery P. Guy Jr.2 David H. Howard3
Received: 15 February 2016 / Accepted: 6 December 2016 / Published online: 26 December 2016 Springer International Publishing Switzerland 2016
AbstractBackground In 2009, the United States Preventive Services Task Force (USPSTF) recommended against routine mammography screening for women aged 4049 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 identied 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 5059 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 4049 years who received at least one mammogram. We also compared the age-specic changes in the proportion of women ages 3559 years who were screened before and after the release of the revised recommendation.
Results The proportion of women screened among the 4049 and 5059 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 4049 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 4049 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.
Keywords Breast cancer USPSTF Mammography
screening Prevention guideline Claims data
Introduction
In November 2009, the United States Preventive Services Task Force (USPSTF) released a new breast cancer recommendation that does not...