title: Mammography rates 3 years after the 2009 US Preventive Services Task Force Guidelines changes.
abstract: OBJECTIVE
  In 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.
  
  
  METHODS
  We 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.
  
  
  RESULTS
  Among 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%).
  
  
  CONCLUSIONS
  Three 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.
authors: All authors: Harvard Medical School; J. Frank Wharam, Fang Zhang, Xin Xu, Stephen Soumerai, and Dennis Ross-Degnan, Harvard Pilgrim Health Care Institute, Boston, MA. jwharam@post.harvard.edu.
authors: J Frank
authors: JF
authors: Wharam
authors: All authors: Harvard Medical School; J. Frank Wharam, Fang Zhang, Xin Xu, Stephen Soumerai, and Dennis Ross-Degnan, Harvard Pilgrim Health Care Institute, Boston, MA.
authors: Bruce
authors: B
authors: Landon
authors: All authors: Harvard Medical School; J. Frank Wharam, Fang Zhang, Xin Xu, Stephen Soumerai, and Dennis Ross-Degnan, Harvard Pilgrim Health Care Institute, Boston, MA.
authors: Fang
authors: F
authors: Zhang
authors: All authors: Harvard Medical School; J. Frank Wharam, Fang Zhang, Xin Xu, Stephen Soumerai, and Dennis Ross-Degnan, Harvard Pilgrim Health Care Institute, Boston, MA.
authors: Xin
authors: X
authors: Xu
authors: All authors: Harvard Medical School; J. Frank Wharam, Fang Zhang, Xin Xu, Stephen Soumerai, and Dennis Ross-Degnan, Harvard Pilgrim Health Care Institute, Boston, MA.
authors: Stephen
authors: S
authors: Soumerai
authors: All authors: Harvard Medical School; J. Frank Wharam, Fang Zhang, Xin Xu, Stephen Soumerai, and Dennis Ross-Degnan, Harvard Pilgrim Health Care Institute, Boston, MA.
authors: Dennis
authors: D
authors: Ross-Degnan
mesh_terms: D000328:Adult; D000368:Aged; D001943:Breast Neoplasms / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000208:ethnology; D005006:Ethnicity; D005260:Female; D006801:Humans; D007348:Insurance, Health; D008327:Mammography / Q000379:methods / Q000592:standards* / Q000706:statistics & numerical data*; D008875:Middle Aged; D017410:Practice Guidelines as Topic; D011315:Preventive Medicine / Q000592:standards*; D015203:Reproducibility of Results; D014481:United States