title: Regional variation in mammography use among insured women 40-49 years old: impact of a USPSTF guideline change.
abstract: OBJECTIVE
  The impact of the US Preventive Services Task Force (USPSTF) recommendation that 40-49 year old women should no longer routinely receive screening mammography in November 2009 in different regions of the US is unknown.
  
  
  METHODS
  We conducted a retrospective cohort study using medical claims from administrative health records from privately insured 40-59 year old women enrolled between 2005 and 2012 to evaluate biennial screening trends.
  
  
  RESULTS
  There was a slight decrease in mammography usage among 40-49 year old US women after the 2008-2009 biennial period (p<0.001). There were some regional differences in mammography trends, with the West showing the greatest difference in odds of 40-49 year olds receiving a mammography in 2011-2012 compared to 2008-2009 (OR: 0.93; 95% CI: 0.91-0.94). Although trends for 50-59 year olds mirrored that of 40-49 year olds, the younger age group had a stronger decline in 2009-2010 and 2010-2011.
  
  
  CONCLUSIONS
  These findings show that USPSTF guideline changes made some differences in mammography usage among 40-49 year olds, but adherence was uneven across regions.
authors.affiliation: Department of Obstetrics and Gynecology, University of Texas Medical Branch, 301 University Blvd Rte 0587, Galveston, TX 77555, .
authors.forename: Jacqueline M
authors.initials: JM
authors.lastname: Hirth
authors.affiliation: Office of Biostatistics, Department of Preventive Medicine and Community Health, University of Texas Medical Branch, 301 University Blvd, Galveston, TX 77555.
authors.forename: Yong-Fang
authors.initials: YF
authors.lastname: Kuo
authors.affiliation: Office of Biostatistics, Department of Preventive Medicine and Community Health, University of Texas Medical Branch, 301 University Blvd, Galveston, TX 77555.
authors.forename: Yu-Li
authors.initials: YL
authors.lastname: Lin
authors.affiliation: Department of Obstetrics and Gynecology, University of Texas Medical Branch, 301 University Blvd Rte 0587, Galveston, TX 77555.
authors.forename: Abbey B
authors.initials: AB
authors.lastname: Berenson