Apr 23, 2013
It has been more than 3 years since the US Preventive Services Taskforce (USPSTF) published controversial guidelines recommending less-frequent mammograms for breast cancer screening. The effect of those guidelines on frequency of screening appears to be negligible. At least that is the conclusion of a survey of nearly 28,000 women. The survey results arepublished online April 19 in Cancer.
Previous guidelines issued by the USPSTF had called for routine screening every 1 to 2 years in women older than 40 years. However, when the USPSTF reviewed the guidelines in 2009, they recommended against routine screening for women aged 40 to 49 years and recommended biennial screening for women aged 50 to 74 years.
The revised guidelines ignited considerable controversy, and since their publication, the American Cancer Society and other medical organizations have stuck to their recommendations that women older than 40 years get annual screenings.
To find out what effect the updated USPSTF recommendations, and the ensuing controversy, have had on screening rates, Lydia E. Pace, MD, MPH, from the Division of Women's Health, Department of Internal Medicine, Brigham and Women's Hospital, Boston, Massachusetts, and colleagues assessed National Health Interview Survey data from 27,829 women.
They focused on how often women chose to be screened, using data collected during 2005, 2008, and 2011 surveys, which provides snapshots of self-reported mammography rates before and after the updated guidelines were issued.
The researchers found that screening rates did not decrease but actually showed a nonsignificant increase.
"The overall unadjusted mammography rates increased over time and were higher in 2011 (54%) than in 2008 (52%; P = .03)," the authors write. However, the difference was not statistically significant after the researchers adjusted for other factors, including race, education, income, immigration status, and insurance level (51.9% in 2008 and 53.6% in 2011; P = .07).
The investigators saw similar results when they divided the study population by age. Among the 40- to 49-year-old women, the adjusted screening rate was 46.1% in 2008 and 47.5% in 2011 (P = .38). Among the women aged 50 to 74 years, the screening rate was 57.2% in 2008 compared with 59.1% in 2011 (P = .09).
"Among all subgroups of women examined, including women who were black, Hispanic, immigrants, less educated, low income, uninsured, or publicly insured, there were no significant decreases in screening for women ages 40 to 49 years or ages 50 to74 years from 2008 to 2011," the authors report.
They add that there may be several reasons why the survey did not show decreased screening. One may be that perhaps it is too early to detect a decline. Another possible explanation is that many providers who refer patients for screening may not agree with the new recommendations, and therefore ignore them. Finally, the researchers note, patients may be continuing to request screenings because they either disagree or do not understand the new recommendations.
Cancer. Published online April 19, 2013. Abstract
Previous guidelines issued by the USPSTF had called for routine screening every 1 to 2 years in women older than 40 years. However, when the USPSTF reviewed the guidelines in 2009, they recommended against routine screening for women aged 40 to 49 years and recommended biennial screening for women aged 50 to 74 years.
The revised guidelines ignited considerable controversy, and since their publication, the American Cancer Society and other medical organizations have stuck to their recommendations that women older than 40 years get annual screenings.
To find out what effect the updated USPSTF recommendations, and the ensuing controversy, have had on screening rates, Lydia E. Pace, MD, MPH, from the Division of Women's Health, Department of Internal Medicine, Brigham and Women's Hospital, Boston, Massachusetts, and colleagues assessed National Health Interview Survey data from 27,829 women.
They focused on how often women chose to be screened, using data collected during 2005, 2008, and 2011 surveys, which provides snapshots of self-reported mammography rates before and after the updated guidelines were issued.
The researchers found that screening rates did not decrease but actually showed a nonsignificant increase.
"The overall unadjusted mammography rates increased over time and were higher in 2011 (54%) than in 2008 (52%; P = .03)," the authors write. However, the difference was not statistically significant after the researchers adjusted for other factors, including race, education, income, immigration status, and insurance level (51.9% in 2008 and 53.6% in 2011; P = .07).
The investigators saw similar results when they divided the study population by age. Among the 40- to 49-year-old women, the adjusted screening rate was 46.1% in 2008 and 47.5% in 2011 (P = .38). Among the women aged 50 to 74 years, the screening rate was 57.2% in 2008 compared with 59.1% in 2011 (P = .09).
"Among all subgroups of women examined, including women who were black, Hispanic, immigrants, less educated, low income, uninsured, or publicly insured, there were no significant decreases in screening for women ages 40 to 49 years or ages 50 to74 years from 2008 to 2011," the authors report.
They add that there may be several reasons why the survey did not show decreased screening. One may be that perhaps it is too early to detect a decline. Another possible explanation is that many providers who refer patients for screening may not agree with the new recommendations, and therefore ignore them. Finally, the researchers note, patients may be continuing to request screenings because they either disagree or do not understand the new recommendations.
Cancer. Published online April 19, 2013. Abstract
It has been more than 3 years since the US Preventive Services Taskforce (USPSTF) published controversial guidelines recommending less-frequent mammograms for breast cancer screening.
The effect of those guidelines on frequency of screening appears to be negligible. At least that is the conclusion of a survey of nearly 28,000 women. The survey results arepublished online April 19 in Cancer.
Previous guidelines issued by the USPSTF had called for routine screening every 1 to 2 years in women older than 40 years. However, when the USPSTF reviewed the guidelines in 2009, they recommended against routine screening for women aged 40 to 49 years and recommended biennial screening for women aged 50 to 74 years.
The revised guidelines ignited considerable controversy, and since their publication, the American Cancer Society and other medical organizations have stuck to their recommendations that women older than 40 years get annual screenings.
To find out what effect the updated USPSTF recommendations, and the ensuing controversy, have had on screening rates, Lydia E. Pace, MD, MPH, from the Division of Women's Health, Department of Internal Medicine, Brigham and Women's Hospital, Boston, Massachusetts, and colleagues assessed National Health Interview Survey data from 27,829 women.
They focused on how often women chose to be screened, using data collected during 2005, 2008, and 2011 surveys, which provides snapshots of self-reported mammography rates before and after the updated guidelines were issued.
The researchers found that screening rates did not decrease but actually showed a nonsignificant increase.
"The overall unadjusted mammography rates increased over time and were higher in 2011 (54%) than in 2008 (52%; P = .03)," the authors write. However, the difference was not statistically significant after the researchers adjusted for other factors, including race, education, income, immigration status, and insurance level (51.9% in 2008 and 53.6% in 2011; P = .07).
The investigators saw similar results when they divided the study population by age. Among the 40- to 49-year-old women, the adjusted screening rate was 46.1% in 2008 and 47.5% in 2011 (P = .38). Among the women aged 50 to 74 years, the screening rate was 57.2% in 2008 compared with 59.1% in 2011 (P = .09).
"Among all subgroups of women examined, including women who were black, Hispanic, immigrants, less educated, low income, uninsured, or publicly insured, there were no significant decreases in screening for women ages 40 to 49 years or ages 50 to74 years from 2008 to 2011," the authors report.
They add that there may be several reasons why the survey did not show decreased screening. One may be that perhaps it is too early to detect a decline. Another possible explanation is that many providers who refer patients for screening may not agree with the new recommendations, and therefore ignore them. Finally, the researchers note, patients may be continuing to request screenings because they either disagree or do not understand the new recommendations.
Cancer. Published online April 19, 2013. Abstract
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