title: Trends in Breast Cancer Screening: Impact of U.S. Preventive Services Task Force Recommendations.
abstract: BACKGROUND
  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 aged younger than 50 years. In this study, screening mammography guideline adherence among U.S. women is explored by examining patterns in rates of mammography age of initiation and utilization in years prior to and following the 2009 USPSTF guideline implementation.
  
  
  METHODS
  U.S. population-based data from the 2007, 2008, 2010, and 2012 Behavioral Risk Factor Surveillance System surveys were used 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.
  
  
  RESULTS
  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).
  
  
  CONCLUSIONS
  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.
authors.affiliation: Department of Radiology, University of Michigan School of Medicine. Electronic address: soudabeh@med.umich.edu.
authors.forename: Soudabeh Fazeli
authors.initials: SF
authors.lastname: Dehkordy
authors.affiliation: Department of Obstetrics and Gynecology, University of Michigan School of Medicine; Institute for Social Research, Population Studies Center.
authors.forename: Kelli S
authors.initials: KS
authors.lastname: Hall
authors.affiliation: Department of Statistics ,University of Michigan, Ann Arbor, Michigan.
authors.forename: Allison L
authors.initials: AL
authors.lastname: Roach
authors.affiliation: Department of Statistics ,University of Michigan, Ann Arbor, Michigan.
authors.forename: Edward D
authors.initials: ED
authors.lastname: Rothman
authors.affiliation: Department of Obstetrics and Gynecology, University of Michigan School of Medicine; University of Michigan Institute for Healthcare Policy and Innovation.
authors.forename: Vanessa K
authors.initials: VK
authors.lastname: Dalton
authors.affiliation: Department of Radiology, University of Michigan School of Medicine; University of Michigan Institute for Healthcare Policy and Innovation; University of Michigan Program for Imaging Comparative Effectiveness and Health Services Research.
authors.forename: Ruth C
authors.initials: RC
authors.lastname: Carlos
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D040343:Behavioral Risk Factor Surveillance System; D001943:Breast Neoplasms / Q000175:diagnosis*; D055088:Early Detection of Cancer / Q000706:statistics & numerical data* / Q000639:trends; D005260:Female; D019983:Guideline Adherence; D006801:Humans; D008327:Mammography / Q000706:statistics & numerical data* / Q000639:trends; D008403:Mass Screening / Q000706:statistics & numerical data* / Q000639:trends; D008875:Middle Aged; D017410:Practice Guidelines as Topic; D014481:United States
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