Applying the Knowledge to Action Framework to Plan a Strategy for Implementing Breast Cancer Screening Guidelines: an Interprofessional Perspective

2013 ◽  
Vol 28 (3) ◽  
pp. 481-487 ◽  
Author(s):  
Sarah Munce ◽  
Monika Kastner ◽  
Heidi Cramm ◽  
Shalini Lal ◽  
Sarah-Maude Deschêne ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Cancer Screening ◽  
Breast Cancer Screening ◽  
Screening Guidelines ◽  
Knowledge To Action

scholarly journals Linking Reminders and Physician Breast Cancer Screening Recommendations: Results From a National Survey

2017 ◽  
pp. 1-10 ◽  
Author(s):  
Elizabeth J. Siembida ◽  
Archana Radhakrishnan ◽  
Sarah A. Nowak ◽  
Andrew M. Parker ◽  
Craig Evan Pollack
Keyword(s):  
Breast Cancer ◽  
Cancer Screening ◽  
Breast Cancer Screening ◽  
Mammography Screening ◽  
Primary Care Physicians ◽  
Age Groups ◽  
National Sample ◽  
Average Risk ◽  
Screening Guidelines ◽  
Practice Characteristics

Purpose Physician reminders have successfully increased rates of mammography. However, considering recent changes to breast cancer screening guidelines that disagree on the optimal age to start and stop mammography screening, we sought to examine the extent to which reminders have been deployed for breast cancer screening targeting younger and older patients. Methods A mailed survey was sent to a national sample of 2,000 primary care physicians between May and September 2016. Physicians were asked whether they received reminders to screen women in various age groups (40 to 44, 45 to 49, and ≥ 75 years), the organizational screening guidelines they trusted most, and whether they recommended routine breast cancer screening to average-risk women in the different age groups. Using regression models, we assessed the association between reminders and physician screening recommendations, controlling for physician and practice characteristics, and evaluated whether the association varied by the guidelines they trusted. Results A total of 871 physicians responded (adjusted response rate, 52.3%). Overall, 28.9% of physicians reported receiving reminders for patient ages 40 to 44 years, 32.5% for patient ages 45 to 49 years, and 16.5% for patient ages ≥ 75 years. Receiving reminders significantly increased the likelihood of physicians recommending mammography screening. In adjusted analyses, 84% (95% CI, 77% to 90%) of physicians who received reminders recommended screening for women ages ≥ 75 versus 65% (95% CI, 62% to 69%) of those who did not receive reminders. The associations between reminders and screening recommendations remained consistent regardless of which guidelines physicians reported trusting. Conclusion Reminders were significantly associated with increases in physician screening recommendations for mammography, underscoring the need for careful implementation in scenarios where guidelines are discordant.

P1-10-07: Comparing Breast Cancer Screening Guidelines: A Stage-Survival-Cost Model in a Public Hospital.

2011 ◽  
Author(s):  
DT Friedman ◽  
C Raskind-Hood ◽  
K Adams ◽  
E Becker ◽  
I Habtes ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Cancer Screening ◽  
Breast Cancer Screening ◽  
Public Hospital ◽  
Cost Model ◽  
Screening Guidelines

scholarly journals The Effect of California’s Breast Density Notification Legislation on Breast Cancer Screening

2016 ◽  
Vol 8 (2) ◽  
pp. 55-62 ◽  
Author(s):  
Stephanie Lynn Chau ◽  
Amy Alabaster ◽  
Karin Luikart ◽  
Leslie Manace Brenman ◽  
Laurel A. Habel
Keyword(s):  
Breast Cancer ◽  
Cancer Screening ◽  
Breast Cancer Screening ◽  
Breast Density ◽  
Screening Mammography ◽  
Median Income ◽  
Cancer History ◽  
Screening Guidelines ◽  
Younger Women ◽  
Dense Breasts

Purpose: Half of US states mandate women be notified if they have dense breasts on their mammogram, yet guidelines and data on supplemental screening modalities are limited. Breast density (BD) refers to the extent that breast tissue appears radiographically dense on mammograms. High BD reduces the sensitivity of screening mammography and increases breast cancer risk. The aim of this study was to determine the potential impact of California’s 2013 BD notification legislation on breast cancer screening patterns. Methods: We conducted a cohort study of women aged 40 to 74 years who were members of a large Northern California integrated health plan (approximately 3.9 million members) in 2011-2015. We calculated pre- and post-legislation rates of screening mammography and magnetic resonance imaging (MRI). We also examined whether women with dense breasts (defined as BI-RADS density c or d) had higher MRI rates than women with nondense breasts (defined as BI-RADS density a or b). Results: After adjustment for race/ethnicity, age, body mass index, medical facility, neighborhood median income, and cancer history, there was a relative 6.6% decrease (relative risk [RR] 0.934, confidence interval [CI] 0.92-0.95) in the rate of screening mammography, largely driven by a decrease among women <50 years. While infrequent, there was a relative 16% increase (RR 1.16, CI 1.07-1.25) in the rate of screening MRI, with the greatest increase among the youngest women. In the postlegislation period, women with extremely dense breasts (BI-RADS d) had 2.77 times (CI 1.93-3.95) the odds of a MRI within 9 months of a screening mammogram compared with women with nondense breasts (BI-RADS b). Conclusions: In this setting, MRI rates increased in the postlegislation period. In addition, women with higher BD were more likely to have supplementary MRI. The decrease in mammography rates seen primarily among younger women may have been due to changes in national screening guidelines.

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