The Impact of Mammography Screening Guideline Changes in a Universally Insured Population

2021 ◽  
Author(s):  
Julie A. Bytnar ◽  
Celia Byrne ◽  
Cara Olsen ◽  
Catherine Witkop ◽  
Mary Beth Martin ◽  
...  
Keyword(s):  
Mammography Screening ◽  
Screening Guideline ◽  
The Impact

scholarly journals The Impact of Mammography Screening Guideline Changes Among Women Serving in the U.S. Military

2020 ◽  
Vol 185 (11-12) ◽  
pp. e2088-e2096
Author(s):  
Julie A Bytnar ◽  
Celia Byrne ◽  
Cara Olsen ◽  
Catherine T Witkop ◽  
Mary Beth Martin ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Racial Disparities ◽  
Mammography Screening ◽  
Women In The Military ◽  
Screening Guidelines ◽  
Screening Guideline ◽  
The Military ◽  
The Impact ◽  
Universal Health ◽  
The U.S

Abstract Introduction The U.S. Preventive Services Task Force (USPSTF) modified their screening guidelines for breast cancer in November 2009. Previous studies evaluated the impact of these guideline changes among privately and Medicare insured populations. Women in the military form a unique population exposed to many social, environmental, and occupational hazards that may increase breast cancer incidence. By evaluating mammography screening rates among women in the military before and after the USPSTF guideline changes, this study evaluated the impact of the USPSTF breast cancer guideline change on screening mammography use within the military population and determined whether current guidelines were followed for this high-risk population with universal health care access. Materials and methods This study evaluated the impact of the 2009 guideline changes among the population of universally insured military servicewomen, comparing the proportion of active duty women aged 40 to 64 receiving mammograms from fiscal years 2006 to 2015 using an interrupted time series analysis. Stratified analyses evaluated differences by age (aged 40–49, 50–64), race, military branch, and rank. This research is considered exempt by the Uniformed Services University Institutional Review Board. Results The proportion of insured military servicewomen receiving mammograms increased from October 2005 through September 2009. A significant decrease occurred in the first quarter of 2010 following the publication of the screening guideline update. From this new baseline, the proportion of women screened increased again through September 2015. Comparative analyses showed more pronounced effects both immediately and over time among the women aged 50 to 64 compared to those aged 40 to 49 years and among older enlisted women compared with their officer counterparts. The patterns were near identical in all subgroups; however, no changes in rate were evident among Air Force and black servicewomen aged 50 to 64 and Army and Navy/Marine Corps servicewomen aged 40 to 49 years. No racial disparities in screening or impact were noted. Conclusions The USPSTF guidelines had differential impacts among some subpopulations. While older women, aged 50 to 64 years, had a greater temporary reduction immediately after the guideline change, younger women aged 40 to 49 years had a longer-term reduction in screening following the guideline changes. No racial disparities in the proportion screened or in the impact of the guideline change were noted in this population with universal health coverage. The lack of Department of Defense standard breast cancer screening guidelines was evident from the different patterns of mammography utilization observed among military branches. To completely understand the impact of the updated screening guidelines, future studies must incorporate research focusing on changes in breast cancer morbidity and mortality as well as updated cost-benefit analyses.

scholarly journals The Impact of Educational Intervention Programs to Promoting Mammography Screening: A Systematic Review

2017 ◽  
Vol 3 (1) ◽  
pp. 58-67 ◽  
Author(s):  
Seyed Mohammad Mehdi Hazavehei ◽  
Khadije Ezzati Rastegar ◽  
Mitra Dogonchi ◽  
Nooshin Salimi ◽  
Elham Gheisvandi
Keyword(s):  
Systematic Review ◽  
Educational Intervention ◽  
Mammography Screening ◽  
Intervention Programs ◽  
The Impact

The impact of mammography screening on the surgical treatment of breast cancer

2018 ◽  
Vol 24 (6) ◽  
pp. 1138-1138 ◽  
Author(s):  
Leonardo Ribeiro Soares ◽  
Ruffo Freitas-Junior
Keyword(s):  
Breast Cancer ◽  
Surgical Treatment ◽  
Mammography Screening ◽  
The Impact

scholarly journals The impact of mammography screening programmes on incidence of advanced breast cancer in Europe: a literature review

BMC Cancer ◽  
2018 ◽  
Vol 18 (1) ◽  
Author(s):  
M. J. M. Broeders ◽  
P. Allgood ◽  
S. W. Duffy ◽  
S. Hofvind ◽  
I. D. Nagtegaal ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Literature Review ◽  
Advanced Breast Cancer ◽  
Mammography Screening ◽  
Advanced Breast ◽  
The Impact

Absence of sustained breast cancer incidence inflation in a national mammography screening programme

2018 ◽  
Vol 26 (1) ◽  
pp. 26-34 ◽  
Author(s):  
Stephen Morrell ◽  
Marli Gregory ◽  
Kerry Sexton ◽  
Jessica Wharton ◽  
Nisha Sharma ◽  
...  
Keyword(s):  
Breast Cancer ◽  
New Zealand ◽  
Cancer Incidence ◽  
Invasive Breast Cancer ◽  
Mammography Screening ◽  
Screening Programme ◽  
Breast Cancer Incidence ◽  
Age Groups ◽  
Incidence Trends ◽  
The Impact

Objective To investigate the impact of population mammography screening on breast cancer incidence trends in New Zealand. Methods Trends in age-specific rates of invasive breast cancer incidence (1994–2014) were assessed in relation to screening in women aged 50–64 from 1999 and 45–69 following the programme age extension in mid-2004. Results Breast cancer incidence increased significantly by 18% in women aged 50–64 compared with 1994–98 (p<0.0001), coinciding with the 1999 introduction of mammography screening, and remained elevated for four years, before declining to pre-screening levels. Increases over 1994–99 incidence occurred in the 45–49 (21%) and 65–69 (19%) age groups following the 2004 age extension (p<0.0001). Following establishment of screening (2006–10), elevated incidence in the screening target age groups was compensated for by lower incidence in the post-screening ⩾70 age groups than in 1994–98. Incidence in women aged ⩾45 was not significantly higher (+5%) after 2006 than in 1994–98. The cumulated risk of breast cancer in women aged 45–84 for 1994–98 was 10.7% compared with 10.8% in 2006–10. Conclusions Increases in breast cancer incidence following introduction of mammography screening in women aged 50–64 did not persist. Incidence inflation also occurred after introduction of screening for age groups 45–49 and 65–69. The cumulated incidence for women aged 45–84 over 2006–10 after screening was well established, compared with 1994–98 prior to screening, shows no increase in diagnosis. Over-diagnosis is not inevitable in population mammography screening programmes.

scholarly journals Improving physician compliance with mammography screening by implementing a breast cancer screening guideline at a hospital in Bahrain

2021 ◽  
Vol 10 (3) ◽  
pp. e001351
Author(s):  
Rabih Mustapha Abou leila ◽  
Michael Shannon ◽  
Sarah El-Nassir El-Nigoumi
Keyword(s):  
Breast Cancer ◽  
Cancer Screening ◽  
Breast Cancer Screening ◽  
Mammography Screening ◽  
Eligible Patient ◽  
Improvement Project ◽  
Screening Guidelines ◽  
Physician Knowledge ◽  
Physician Compliance ◽  
Screening Guideline

BackgroundFrom a health and safety perspective, it is critical to use adequate, evidence-based breast screening guidelines. The aim of this quality improvement project was to improve physicians’ compliance with breast cancer screening guidelines to enhance the mammography screening rate among eligible women; this was achieved through the implementation of multifaceted changes to the hospital’s processes and the improvement of physicians’ attitudes towards the guidelines.MethodsThe project used the Plan-Do-Study-Act method to implement the changes. This was a pre-post evaluation study. The data were collected from patients’ charts. The primary outcome of interest was the rate of physician compliance with mammography screening guidelines before and after the implementation of the process changes. A literature review was conducted to determine which women should be identified as eligible for mammography screening.InterventionThe interventions targeted physician knowledge and hospital processes. Improving doctors’ expertise was achieved by implementing the US Preventive Service Task Force recommendation for mammography screening every 2 years for women aged 50–74 years. The process modifications included the establishment of a system that would be effective in identifying at-risk patients and reminding physicians at the point of care.ResultsOver the course of this study, 825 patients met the criteria for breast cancer screening. The rate of physician compliance with the breast cancer screening guideline increased from 2% to 69% after 23 weeks, and the control charts demonstrated a reliable process.ConclusionThis project examined the relationship between different interventions (identification of the eligible patient, reminder alerts and physician knowledge) and physician compliance with mammography screening guidelines. The results suggest a positive link between the study variables and physicians’ compliance with mammography screening guidelines.

Frequency of late-stage breast cancer diagnoses despite high mammography screening rates in an HMO

2009 ◽  
Vol 27 (15_suppl) ◽  
pp. 1526-1526
Author(s):  
R. Haque ◽  
J. E. Schottinger ◽  
M. H. Kanter ◽  
C. C. Avila ◽  
R. Contreras ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Late Stage ◽  
Mammography Screening ◽  
Early Stage ◽  
Advanced Tumor Stage ◽  
Early Stage Disease ◽  
Advanced Tumor ◽  
Stage Disease ◽  
Late Stage Diagnosis ◽  
The Impact

1526 Background: Kaiser Permanente Southern California (KPSC) led the nation in screening women for breast cancer (BCa) with a mammography rate of nearly 90% in 2007 according to 2008 Healthcare Effectiveness Data and Information Set (HEDIS) measures. Despite successes in improving screening rates in this health plan that serves 3+ million diverse members, the percentage of women diagnosed with late stage BCa (stage III, IV) remained stable, varying from 12.9% (N∼323) in 2003 to 10.8% (N∼270) in 2007. To identify patient and health care factors associated with late stage diagnosis and the impact of its enhanced screening implementation guidelines, KPSC undertook this study. Methods: This cross-sectional study included a cohort of 10,580 BCa patients from 2003–2007. We compared women diagnosed with late stage disease versus those with early stage disease (stages I, II). P values (2-sided) were based on the chi-square distribution. Adjusted odds ratios and 95% confidence intervals were estimated using unconditional logistic regression. Results: Factors that were positively associated with late stage diagnosis in the univariate analyses included age, lack of recent mammography screening, worse tumor features, 80+ years of age, minority race, lower geocoded household income, increased healthcare visits, and use of Pap testing (P < 0.01 for all variables). Factors significantly associated with late stage diagnosis in the multivariate model included only lack of recent mammography screening (OR = 1.35, 95% CI: 1.14–1.58) and worse tumor features including high grade (grade 3, OR = 2.58, 95% CI: 1.96–3.40), positive lymph nodes (OR = 53.49, 95% CI: 39.90–71.72), and HER-2+ tumors (OR = 1.40, 95% CI: 1.13–1.72). Conclusions: Targeting older women, those with lower utilization, and women who did not have a recent mammogram may help further lower the prevalence of late stage diagnoses. However, given the extent of the health plan's previous efforts to enhance BCa screening rates, a ceiling effect may limit additional benefit. Additional efforts to decrease the rate of advanced tumor stage at diagnosis may include improving interpretation of mammograms or earlier detection of aggressive tumors by enhanced BRCA genetic testing. No significant financial relationships to disclose.

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