title: National Trends and Disparities in Mammography Among Commercially Insured Women, 2001-2010.
abstract: BACKGROUND
  Prior research suggests that mammography declined from 2000 to 2005 and that socioeconomic disparities remained wide.
  
  
  OBJECTIVE
  To assess national trends and disparities in mammography among commercially insured women from 2001 to 2010.
  
  
  METHODS
  This study used a longitudinal time series design to examine mammography rates among 5.4 million US women aged 40 to 64 years from 2001 to 2010. Adjusted annual rates stratified by age group (40-49 years/50-64 years) and neighborhood-level socioeconomic characteristics including poverty and race/ethnicity were plotted. Mammography disparities were defined as the absolute percentage difference in adjusted screening rates between population subgroups in a given year. Trends in 2001-2010 screening rates and socioeconomic disparities were fitted as annual percentage changes (APCs) using join point analysis, which can determine changes in trends.
  
  
  METHODS
  Annual and biennial mammogram.
  
  
  RESULTS
  Adjusted annual mammography rates among women aged 40 to 49 years increased from 38.5% to 45.5% (0.78% APC, P < .001) over the decade. Among women aged 50 to 64 years, 2001-2004 rates decreased from 49.7% to 47.4% (-0.78% APC, P = .035) and then increased to 51.8% by 2010 (APC of 0.80%, P < .001). Women aged 40 to 49 years had an unchanged high-low neighborhood poverty screening disparity of 11.0% over the decade (APC -0.05%, P = .508). The estimated white-black disparity decreased from 9.6% to 7.7% from 2001 to 2010 (-0.21% APC, P = .042). The white-Hispanic disparity decreased from 9.6% to 6.2% between 2001 and 2003 (APC -1.69%, P = .143) and then to 5.3% by 2010 (APC -0.14%, P = .343). Among women aged 50 to 64 years, estimated high-low poverty and white-black disparities declined (11.0%-9.5% [-0.16% APC, P = .026] and 8.6%-6.3% [-0.26% APC, P = .008], respectively) while the white-Hispanic disparity decreased from 14.9% to 5.4% between 2001 and 2003 (-4.77% APC, P = .023) and was 6.5% by 2010.
  
  
  CONCLUSIONS
  Mammography increased among women aged 40 to 49 years from 2001 to 2010 and after 2004 among women aged 50 to 64 years. Women from black and Hispanic neighborhoods experienced reduced disparities, but disparities by poverty level changed little.
authors.affiliation: Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, Massachusetts (Drs Wharam, Zhang, and Ross-Degnan and Mr Xu); Department of Health Care Policy, Harvard Medical School, Boston, Massachusetts (Dr Landon).
authors.forename: J Frank
authors.initials: JF
authors.lastname: Wharam
authors.forename: Bruce E
authors.initials: BE
authors.lastname: Landon
authors.forename: Xin
authors.initials: X
authors.lastname: Xu
authors.forename: Fang
authors.initials: F
authors.lastname: Zhang
authors.forename: Dennis
authors.initials: D
authors.lastname: Ross-Degnan
mesh_terms: D000328:Adult; D001943:Breast Neoplasms / Q000000981:diagnostic imaging*; D005260:Female; D054625:Healthcare Disparities; D006801:Humans; D019458:Insurance Coverage; D008137:Longitudinal Studies; D008327:Mammography / Q000706:statistics & numerical data*; D008875:Middle Aged; D012959:Socioeconomic Factors; D014481:United States