Trends in Breast Cancer Screening: Impact of U.S. Preventive Services Task Force Recommendations.
Trends in Breast Cancer Screening: Impact of U.S. Preventive Services Task Force Recommendations.
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DOI：
10.1016/j.amepre.2015.02.017
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发表时间：
2015-09
影响因子：
5.5
通讯作者：
Carlos RC
中科院分区：
文献类型：
--
作者：
Dehkordy SF;Hall KS;Roach AL;Rothman ED;Dalton VK;Carlos RC
虽然在常规筛查乳房X线摄影的益处方面，各种指南之间存在普遍共识，但筛查开始的年龄和测试的最佳频率仍然存在争议。2009年，美国预防服务工作组（USPSTF）建议对50岁以下的女性进行常规乳腺癌筛查。在这项研究中，我们通过检查2009年USPSTF指南实施之前和之后的乳腺X线摄影开始和使用年龄的比率模式，探索美国妇女对乳腺X线摄影筛查指南的遵守情况。我们使用2007年、2008年、2010年和2012年行为风险因素监测系统调查的美国人口数据，按年龄和调查年份衡量去年接受筛查性乳房X光检查的女性比例的总体比例和变化率。2014年7月访问并分析了数据。与2007年和2008年相比，2010年和2012年的乳房X线摄影筛查率较低（p<0.0001）。40岁时开始筛查的比率随时间增加，并且在USPSTF指南变更后的年份中最高（p=0.012）。这些数据支持在USPSTF指南修订的3年内，美国妇女在开始筛查乳腺X线摄影年龄时的模式没有明显变化。这一发现是否反映了指南修订对人口趋势的延迟影响，或者更确切地说是卫生提供者的做法和患者对更频繁筛查的偏好尚不清楚，需要进一步调查。
Although there is general agreement among various guidelines on benefits of routine screening mammography, the age of screening initiation and the optimal frequency of the test remain controversial. In 2009, the U.S. Preventive Services Task Force (USPSTF) recommended against routine breast cancer screening in women younger than age 50 years. In this study, we explore screening mammography guideline adherence among U.S. women by examining patterns in rates of mammography age of initiation and utilization in years prior to and following 2009 USPSTF guideline implementation. We used U.S. population–based data from the 2007, 2008, 2010, and 2012 Behavioral Risk Factor Surveillance System surveys to measure the overall proportion and rate of change in the proportion of women who underwent screening mammography within the last year, by age and survey year. Data were accessed and analyzed in July 2014. Rates of mammography screening were lower in 2010 and 2012 compared with 2007 and 2008 (p<0.0001). The rate of screening initiation at age 40 years increased over time and was the highest in the years following USPSTF guideline changes (p=0.012). These data support no perceptible change in U.S. women’s patterns of screening mammography age at initiation within 3 years of the USPSTF guideline revision. Whether this finding reflects a delayed effect of guideline revision in population trends or rather health provider practice and patient preference for more frequent screening is unclear and requires further investigation.