Registry-based study of trends in breast cancer screening mammography before and after the 2009 U.S. Preventive Services Task Force recommendations.
OBJECTIVE
To determine whether the 2009 U.S. Preventive Services Task Force (USPSTF) guidelines for breast cancer mammography screening were followed by changes in screening utilization in the state of Vermont.


METHODS
This retrospective study was HIPAA compliant and approved by the institutional review board, with waiver of informed consent. Trends in screening mammography utilization during 1997-2011 were examined among approximately 150,000 women aged 40 years and older in the state of Vermont using statewide mammography registry data.


RESULTS
The percentage of Vermont women aged 40 years and older screened in the past year declined from 45.3% in 2009% to 41.6% in 2011 (an absolute decrease of -3.7 percentage points; 95% confidence interval [CI]: -3.3, -4.1). The largest decline in utilization was among women aged 40-49 years (-4.8 percentage points; 95% CI: -4.1, -5.4), although substantial declines were also observed among women aged 50-74 years (-3.0 percentage points; 95% CI: -2.6, -3.5) and women aged 75 years and older (-3.1 percentage points; 95% CI: -2.3, -4.0). The percentage of women aged 50-74 years screened within the past 2 years declined by -3.4 percentage points (95% CI: -3.0, -3.9) from 65.4% in 2009 to 61.9% in 2011.


CONCLUSIONS
After years of increasing screening mammography utilization in Vermont, there was a decline in screening, which coincided with the release of the 2009 USPSTF recommendations. The age-specific patterns in utilization were generally consistent with the USPSTF recommendations, although there was also evidence that the percentage of women aged 50-74 years screened in the past 2 years declined since 2009.
From the Department of Surgery, University of Vermont, 1 S Prospect St, Burlington, VT 05401.
Brian L
BL
Sprague
Kenyon C
KC
Bolton
John L
JL
Mace
Sally D
SD
Herschorn
Ted A
TA
James
Pamela M
PM
Vacek
Donald L
DL
Weaver
Berta M
BM
Geller
D000328:Adult; D000368:Aged; D001943:Breast Neoplasms / Q000000981:diagnostic imaging* / Q000453:epidemiology; D055088:Early Detection of Cancer; D005260:Female; D019983:Guideline Adherence; D006801:Humans; D008327:Mammography; D008403:Mass Screening / Q000706:statistics & numerical data / Q000639:trends*; D008875:Middle Aged; D017410:Practice Guidelines as Topic; D012042:Registries; D012189:Retrospective Studies; D014481:United States / Q000453:epidemiology; D014707:Vermont / Q000453:epidemiology