scholarly journals Breast cancer screening patterns in Jamaican women: review of the largest national mammography clinic

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Sheray N. Chin ◽  
Derria Cornwall ◽  
Derek I. Mitchell ◽  
Michael E. McFarlane ◽  
Joseph M. Plummer
Keyword(s):  
Breast Cancer ◽  
Cancer Screening ◽  
Breast Cancer Screening ◽  
Breast Cancer Diagnosis ◽  
Mammographic Screening ◽  
Screening Mammography ◽  
Screening Guidelines ◽  
National Breast ◽  
Jamaican Women ◽  
The Impact

Abstract Background Breast cancer is the leading cause of cancer and cancer related deaths in Jamaican women. In Jamaica, women often present with advanced stages of breast cancer, despite the availability of screening mammography for early detection. The utilization of screening mammography for early breast cancer diagnosis seems to be limited, and this study investigated the national patterns of mammographic screening and the impact of mammography on the diagnosis of breast cancer in Jamaica. Methods A retrospective analysis of the records of the largest mammography clinic in Jamaica was done for the period January 2011 to December 2016. Descriptive statistics was performed on relevant patient characteristics with calculation of rates and proportions; cross-tabulations were utilized to assess relationship of covariates being studied on the outcomes of interest. Results are reported in aggregate form with no identifiable patient data. Results 48,203 mammograms were performed during the study period. 574 women (1.2%) had mammograms suspicious for breast cancer with median age of 57 years (range 30–95 years); 35% were under the age of 50. 4 women with suspicious findings had undergone ‘screening mammography’, with the remaining having ‘diagnostic mammography’. 38% reported previous mammograms, with a mean interval of 8 years between previous normal mammogram and mammogram suspicious for breast cancer. Median age at first screening mammogram was 51 years (range 41–77). Conclusion Breast cancer screening mammography is underutilized in Jamaica. An organized national breast cancer screening programme is recommended to improve adherence to international breast cancer screening guidelines.

Breast Cancer screening patterns in Jamaican women: review of the largest national mammography clinic

2020 ◽  
Author(s):  
Sheray N Chin ◽  
Derria Cornwall ◽  
Derek Mitchell ◽  
Michael McFarlane ◽  
Joseph Plummer
Keyword(s):  
Breast Cancer ◽  
Cancer Screening ◽  
Breast Cancer Screening ◽  
Breast Cancer Diagnosis ◽  
Screening Mammography ◽  
Screening Guidelines ◽  
National Breast ◽  
Abnormal Mammogram ◽  
Jamaican Women ◽  
The Impact

Abstract Background Breast cancer is the leading cause of cancer and cancer related deaths in Jamaican women. In Jamaica, women often present with advanced stages of breast cancer, despite the availability of screening mammography for early detection. The utilization of screening mammography for early breast cancer diagnosis seems to be limited, and this study investigated the national patterns of mammographic screening and the impact of mammography on the diagnosis of breast cancer in Jamaica.Methods A retrospective analysis of the records of the largest mammography clinic in Jamaica was done for the period January 2011 to December 2016. Descriptive statistics was performed on relevant patient characteristics with calculation of rates and proportions; cross-tabulations were utilized to assess relationship of covariates being studied on the outcomes of interest. Results are reported in aggregate form with no identifiable patient data.Results 48,203 mammograms were performed during the study period. 574 women (1.2%) had mammograms suspicious for breast cancer with median age of 57 years (range 30 – 95 years); 35% were under the age of 50. 4 women with suspicious findings had undergone ‘routine mammography’, with the remaining having ‘diagnostic mammography’. 38% reported previous mammograms, with a mean interval of 8 years between previous normal mammogram and abnormal mammogram. Median age at first screening mammogram was 51 years (range 41-77).Conclusion Breast cancer screening mammography is underutilized in Jamaica. An organized national breast cancer screening programme is recommended to improve adherence to international breast cancer 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.

Impact of the U.S. Preventive Services Task Force update for breast cancer screening on mammography utilization in women age 40 to 49.

2012 ◽  
Vol 30 (27_suppl) ◽  
pp. 5-5
Author(s):  
Amy T. Wang ◽  
Jiaquan Fan ◽  
Holly K. Van Houten ◽  
Nilay D. Shah
Keyword(s):  
Breast Cancer ◽  
Time Series ◽  
Cancer Screening ◽  
Breast Cancer Screening ◽  
Task Force ◽  
Screening Mammography ◽  
Administrative Claims ◽  
Post Intervention ◽  
Start Date ◽  
The Impact

5 Background: The 11/2009 USPSTF breast cancer screening update recommended against routine screening mammography for women age 40-49, created confusion and prompted organizations to release opposing statements. We aimed to determine if the USPSTF update for breast cancer screening impacted screening mammography utilization in women age 40-49. Methods: We conducted a time-series analysis utilizing administrative claims data from over 100 health plans. Women ages 40-64 with at least one month of enrollment from 01/2006-12/2010 were included. Medicare claims are not included and thus women ≥65 were excluded. The start date of 01/2006 was chosen to account for possible effects of the recent recession. We developed claims-based algorithms to identify the number of monthly screening mammograms. Time series models were fit using SAS PROC AUTOREG; strong seasonal fluctuations were adjusted by including an autoregressive error of order 12. Results: Over 7.9 million women were included. Prior to the intervention, the baseline monthly mammography rate was 40.9/1,000 women for the 40-49 group and 47.4/1,000 women for the 50-64 group. Based on projections from pre-intervention trends, the update was associated with a 5.72% (1.27,10.18) and 4.97% (1.11,8.84) decrease in mammography rate at 3 and 10 months post-intervention, respectively in the 40-49 group. The intervention had no effect on mammography rates in the 50-64 group. This translates to 53,969 fewer mammograms performed in the year following the update for women ages 40-49 in this dataset. Conclusions: We present the first estimates of the impact of the USPSTF breast cancer screening update using a large nationally representative database. The update was associated with a small but significant decrease in mammography rates for women ages 40-49, while no change was seen for women ages 50-64, which is consistent with the context of the guideline change. A modest effect is also in line with public backlash and the release of numerous conflicting guidelines. These findings underscore the need for further research on benefits and risks of screening mammography as it is difficult to act on numerous sources of contradictory information.

scholarly journals Evaluation issues in the Swedish Two-County Trial of breast cancer screening: An historical review

2016 ◽  
Vol 24 (1) ◽  
pp. 27-33 ◽  
Author(s):  
Laszlo Tabar ◽  
Tony Hsiu-Hsi Chen ◽  
Chen-Yang Hsu ◽  
Wendy Yi-Ying Wu ◽  
Amy Ming-Fang Yen ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Cancer Screening ◽  
Breast Cancer Screening ◽  
Controlled Trial ◽  
Historical Review ◽  
Breast Cancer Diagnosis ◽  
Mammographic Screening ◽  
Control Group ◽  
Full Account ◽  
Research Issues

Objectives To summarize debate and research in the Swedish Two-County Trial of mammographic screening on key issues of trial design, endpoint evaluation, and overdiagnosis, and from these to infer promising directions for the future. Methods A cluster-randomized controlled trial of the offer of breast cancer screening in Sweden, with a single screen of the control group at the end of the screening phase forms the setting for a historical review of investigations and debate on issues of design, analysis, and interpretation of results of the trial. Results There has been considerable commentary on the closure screen of the control group, ascertainment of cause of death, and cluster randomization. The issues raised were researched in detail and the main questions answered in publications between 1989 and 2003. Overdiagnosis issues still remain, but methods of estimation taking full account of lead time and of non-screening influences on incidence (taking place mainly before 2005) suggest that it is a minor phenomenon. Conclusion Despite resolution of issues relating to this trial in peer-reviewed publications dating from years, or even decades ago, issues that already have been addressed continue to be raised. We suggest that it would be more profitable to concentrate efforts on current research issues in breast cancer diagnosis, treatment, and prevention.

scholarly journals A method for evaluating breast cancer screening strategies using screen-preventable loss of life

PLoS ONE ◽  
2020 ◽  
Vol 15 (12) ◽  
pp. e0243113
Author(s):  
Kimbroe J. Carter ◽  
Frank Castro ◽  
Roy N. Morcos
Keyword(s):  
Breast Cancer ◽  
Cancer Screening ◽  
Breast Cancer Screening ◽  
Task Force ◽  
Mammographic Screening ◽  
American Cancer Society ◽  
Cancer Society ◽  
Loss Of Life ◽  
Screening Guidelines ◽  
Clinical Awareness

The objective of this study is to describe how screen-preventable loss of life (screen-PLL) can be used to analyze the distribution of life savings with mammographic screening. The determination of screen-PLL with mammography is possible using a natural history model of breast cancer that simulates clinical and pathologic events of this disease. This investigation uses a Monte Carlo Markov model with data from the Surveillance, Epidemiology, and End Results Program; American Cancer Society; and National Vital Statistics System. Populations of one million women per screening strategy are simulated over a lifetime with mammographic screening based on current guidelines of the American Cancer Society (ACS), United States Preventive Services Task Force (USPSTF), triennial screening from age 50–70, and no screening. Screen-PLL curves are generated and show guideline performance over a lifetime. The screen-PLL curve with no screening is determined by tumor discovery through clinical awareness and has the highest values of screen-PLL. The ACS and USPSTF strategies demonstrate screen-PLL curves favoring the elderly. The curve for triennial screening is more uniform than the ACS or USPSTF curves but could be improved by adding screen(s) at either end of the 50–70 age range. This study introduces the use of screen-PLL as a tool to improve the understanding of screening guidelines and allowing a more balanced allocation of life savings across an aging population. The method presented shows how screen-PLL can be used to analyze and potentially improve breast cancer screening guidelines.

scholarly journals Disability as a predictor of breast cancer screening uptake: A population-based study of 57,328 women

2019 ◽  
Vol 27 (4) ◽  
pp. 194-200
Author(s):  
Emma Ross ◽  
Aideen Maguire ◽  
Michael Donnelly ◽  
Adrian Mairs ◽  
Clare Hall ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Cancer Screening ◽  
Northern Ireland ◽  
Breast Cancer Screening ◽  
Breast Screening ◽  
The United States ◽  
Ageing Population ◽  
Screening Uptake ◽  
National Breast ◽  
The Impact

Objective Despite a growing body of evidence suggesting inequalities in breast cancer screening uptake in the United States for women with disabilities, few attempts have been made to examine whether this association applies to the United Kingdom. We conducted the first population-wide study investigating the impact of disability on uptake of breast cancer screening in Northern Ireland. Methods Breast screening records extracted from the National Breast Screening System were linked to the Northern Ireland Longitudinal Study. This identified a cohort of 57,328 women who were followed through one complete three-year screening cycle of the National Health Service Breast Screening Programme in Northern Ireland. The presence of disability was identified from responses to the 2011 Census. Results Within this cohort, 35.8% of women reported having at least one chronic disability, and these individuals were 7% less likely to attend compared with those with no disability (odds ratio 0.93; 95% confidence interval 0.89–0.98). Variation in the degree of disparity observed was evident according to the type and number of comorbid disabilities examined. Conclusion This is the first population-wide study in Northern Ireland to identify disparities in breast screening uptake for women with chronic disabilities, in particular, those with multimorbidity. This is of particular concern, given the projected rise in the prevalence of disability associated with the ageing population.

scholarly journals Does mammographic screening and a negative result affect attitudes towards future breast screening?

2001 ◽  
Vol 8 (4) ◽  
pp. 204-212 ◽  
Author(s):  
C.H.C. Drossaert ◽  
H. Boer ◽  
E.R. Seydel
Keyword(s):  
Breast Cancer ◽  
Cancer Screening ◽  
Breast Cancer Screening ◽  
Mammographic Screening ◽  
Breast Examination ◽  
Before And After ◽  
Cancer Screening Programme ◽  
High Level ◽  
Repeat Participation ◽  
The Impact

OBJECTIVES:To investigate the impact of an experience of a benign mammographic result on intention to seek medical help immediately in the case of breast abnormalities, and on intentions and thoughts about future participation in screening. SETTING:The Dutch Breast Cancer Screening Programme for women aged 50–69. METHODS:Subjects were women who were invited for an initial breast examination: 223 women filled out a questionnaire about 10 days before and about 6 weeks after their initial breast examination. To be able to control for possible test effects, another group of 293 women filled out a questionnaire only after mammography. Changes in thoughts and intentions were examined. RESULTS:Most women were very satisfied with the course of their initial breast examination, although pain or discomfort was often mentioned. No clues to suggest false reassurance were found: more than 99% of the women would consider the possibility of breast cancer if they felt a lump in one of their breasts. In such a situation, most women intended to seek medical help within a week. These variables were not influenced by the experience of mammography with a benign result. In general, women were very positive about (repeat) participation, both before and after screening. After screening, the average woman perceived fewer costs in participating, and perceived her own ability to engage in future screening as higher. However, the experience of pain and anxiety during the initial screening did lead to reverse effects. Women who were less satisfied about their treatment by the staff were more likely to change their intentions to reparticipate in a negative way. CONCLUSIONS:As, in general, women became more positive about regular participation after they had attended breast cancer screening, efforts to improve first round attendance must be continued. At the same time, the screening organisations must continue to prioritise the high level of client friendliness throughout the screening. No evidence for detrimental effects of screening through false reassurance among participants was found.

scholarly journals Screening Mammography: Guidelines versus Clinical Practice

2020 ◽  
Vol 2 (3) ◽  
pp. 217-224 ◽  
Author(s):  
Rebecca Oudsema ◽  
Esther Hwang ◽  
Sharon Steinberger ◽  
Rowena Yip ◽  
Laurie R Margolies
Keyword(s):  
Breast Cancer ◽  
Clinical Practice ◽  
Cancer Screening ◽  
Medical Students ◽  
Breast Cancer Screening ◽  
The United States ◽  
Screening Mammography ◽  
Medical Specialties ◽  
Patients Âgés ◽  
The Impact

Abstract Objective To understand physicians’ comprehension of breast cancer screening guidelines and the existing literature on breast cancer screening, and whether this contributes to how patient screening is implemented in clinical practice. Methods A survey of 18 questions was distributed across the United States via e-mail and social media resources to physicians and medical students of all disciplines and levels of training. Responses from 728 physicians and medical students were reviewed. Respondents were from over 200 different institutions and over 60 different medical specialties. Results Our survey demonstrates that more than half of the participants felt uncomfortable in their knowledge of breast cancer screening recommendations (399/728, 54.8%) and existing literature on breast cancer screening (555/728, 76.2%). When stratified based on level of training, those at the attending level reported a greater level of comfort in their knowledge of breast cancer screening recommendations (168/238, 70.6%) and literature (95/238, 39.9%) compared with respondents at the trainee level. Attending physicians are also more likely to recommend screening for patients between the ages of 40–49 years old (209/238, 87.7%) compared to those at the trainee level. Responses on whether to screen based on age were most consistent for patients ages 50–74, with greater than 90% of the respondents endorsing screening mammogram for this age group in all levels of training. There were greater inconsistencies in the support to screen age groups 40–49 and 75+ . Conclusions The results showed a disparity in screening practices by clinicians in all levels of training, particularly for patients ages 40–49 and 75+ , and for the interval of screening. Later initiation with less frequent intervals between screens may reduce the impact of screening on mortality reduction.

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