Mammography Rates 3 Years After the 2009 US Preventive Services Task Force Guidelines Changes
Mammography Rates 3 Years After the 2009 US Preventive Services Task Force Guidelines Changes
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DOI：
10.1200/jco.2014.56.9848
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发表时间：
2015-03-20
影响因子：
45.3
通讯作者：
Ross-Degnan, Dennis
中科院分区：
文献类型：
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作者：
Wharam, J. Frank;Landon, Bruce;Ross-Degnan, Dennis
目的2009年11月，美国预防服务工作组（USPSTF）将其乳房X光检查建议从40岁女性每1至2年一次改为40至49岁女性每2年一次的个性化筛查决定，以及50至74岁女性每2年一次的筛查。国家健康保险公司。我们使用2005年至2009年乳房X光检查趋势来预测2012年的发病率。我们的主要指标是2012年年度和两年期乳腺X线摄影率的观察值和预测值之间的估计差异。我们分层结果按年龄组和种族/ethnication.ResultsAmong妇女年龄在40至49岁，2012年乳房X线摄影率下降了9.9%（95%CI，-10.4%至-9.3%），相对于2012年的预测率。黑人女性的下降幅度最低（-2.3%; 95% CI，-6.3%至1.8%），亚裔女性的下降幅度最高（-17.4; 95% CI，-20.0至14.8）。到2012年，50至64岁女性的年度乳房X光检查率下降了6.1%（95% CI，-6.5%至5.7%）。关于两年一次的乳房X线摄影率，40至49岁的女性经历了9.0%的相对降低（95% CI，-9.6%至8.4%）。40 - 49岁的白色、西班牙裔和亚裔女性表现出相似的相对降低，约为9%-11%，而黑人女性未检测到变化（0.1%; 95% CI，-4.0%至4.3%）。50至64岁的女性每两年进行一次乳房X光检查时相对减少6.2%（95%CI，-6.6%至-5.7%），这在白色、西班牙裔和亚洲女性中相似。黑人妇女年龄在50至64岁没有变化，在两年一次的乳房X光检查（0.4%; 95%CI，-2.6%至3.5%hold.ConclusionThree年后出版的2009年USPSTF指南，乳房X光检查率下降了6%至17%之间的白色，西班牙裔和亚洲妇女，但不是黑人妇女。两年一次的乳房X光检查的小幅减少可能是更新指南的意外后果。(C)2015年美国临床肿瘤学会
PurposeIn November 2009, the US Preventive Services Task Force (USPSTF) changed its mammography recommendations from every 1 to 2 years among women age 40 years to personalized screening decisions for women age 40 to 49 years and screening every 2 years for women age 50 to 74 years.MethodsWe studied mammography trends among 5.5 million women age 40 to 64 years enrolled in a large national health insurer. We used 2005 to 2009 mammography trends to predict 2012 rates. Our primary measure was the estimated difference between observed and predicted 2012 annual and biennial mammography rates. We stratified results by age group and race/ethnicity.ResultsAmong women age 40 to 49 years, 2012 mammography rates declined by 9.9% (95% CI, -10.4% to -9.3%) relative to the predicted 2012 rate. Decreases were lowest among black women (-2.3%; 95% CI, -6.3% to 1.8%) and highest among Asian women (-17.4; 95% CI, -20.0 to -14.8). Annual mammography rates among women age 50 to 64 years declined by 6.1% (95% CI, -6.5% to -5.7%) by 2012. Regarding biennial mammography rates, women age 40 to 49 years experienced a 9.0% relative reduction (95% CI, -9.6% to -8.4%). White, Hispanic, and Asian women age 40 to 49 years demonstrated similar relative reductions of approximately 9% to 11%, whereas black women had no detectable changes (0.1%; 95% CI, -4.0% to 4.3%). Women age 50 to 64 years had a 6.2% relative reduction (95% CI, -6.6% to -5.7%) in biennial mammography that was similar among white, Hispanic, and Asian women. Black women age 50 to 64 years did not have changes in biennial mammography (0.4%; 95% CI, -2.6% to 3.5%).ConclusionThree years after publication of the 2009 USPSTF guidelines, mammography rates declined by 6% to 17% among white, Hispanic, and Asian women but not among black women. Small reductions in biennial mammography might be an unintended consequence of the updated guidelines. (C) 2015 by American Society of Clinical Oncology