Targeting of mammography screening according to life expectancy in women aged 75 and older.
Targeting of mammography screening according to life expectancy in women aged 75 and older.
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DOI：
10.1111/jgs.12123
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发表时间：
2013-03
影响因子：
6.3
通讯作者：
McCarthy EP
中科院分区：
文献类型：
--
作者：
Schonberg MA;Breslau ES;McCarthy EP
To examine receipt of mammography screening by life expectancy (LE) among women ≥75 years. Cross-sectional survey of community dwelling US women ≥75 years that participated in the 2008 or 2010 National Health Interview Survey. Using an index we previously developed and validated, we categorized women according to life expectancy (>9-years, 5–9 years, <5-years). We examined receipt of mammography screening in the past 2 years by life expectancy adjusting for sociodemographics, access to care, preventive orientation (e.g., receipt of flu vaccination), and receipt of a clinician recommendation for screening. Of 2,266 respondents, 27.1% had >9-years LE, 53.4% had 5–9 years LE, and 19.5% had <5-years LE. Overall, 55.7% reported receiving mammography screening in the past 2 years. Life expectancy was strongly associated with receipt of screening (p<0.001); yet, 36.1% of women with <5-years LE were screened while 29.2% of women with >9-years LE were not screened. A clinician recommendation for screening was the strongest predictor of screening independent of life expectancy. Higher educational attainment, age, receipt of flu vaccination, and history of benign breast biopsy, were also independently associated with being screened. Despite uncertainty of benefit, many women >75 years are screened with mammography. Life expectancy is strongly associated with receipt of screening which may reflect clinicians and patients appropriately considering LE in screening decisions. However, 36% of women with short LEs are still screened suggesting new interventions are needed to further improve targeting of screening by LE. Patient decision aids and guidelines encouraging clinicians to consider patient LE in screening decisions may improve care.
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