title: Mammography Use and Physician Recommendation After the 2009 U.S. Preventive Services Task Force Breast Cancer Screening Recommendations.
abstract: BACKGROUND
  In 2009, the U.S. Preventive Services Task Force (USPSTF) no longer recommended routine mammography for women aged 40-49 and ≥75 years (younger and older women, respectively). Whether mammography usage and physician recommendation among younger and older women changed in response to these recommendations is unclear.
  
  
  METHODS
  Cross-sectional data from women aged ≥40 years in the 2008 and 2013 National Health Interview Surveys were used (n=4,942 younger and 3,047 older women) and were analyzed in 2015. Changes between 2008 and 2013 in self-reports about having undergone mammography in the past 2 years and physician recommendation for mammography were expressed as adjusted prevalence difference (PD) and 95% CI.
  
  
  RESULTS
  Overall, adjusted prevalence of mammography among younger women was similar in 2008 (62.2%) and 2013 (58.5%) (p=0.05), but significantly declined in high-income (PD=-6.1%, 95% CI=-11.2, -1.0); non-Hispanic white (PD=-5.5%, 95% CI=-10.2, -0.8); and privately insured (PD=-5.7%, 95% CI=-9.8, -1.6) younger women. For older women, there was no change in adjusted mammography prevalence overall (2008, 56.2%; 2013, 54.2%; p=0.473) or by SES. Physician mammography recommendation declined in younger (PD=-5.0%, 95% CI=-8.7, -1.3) and older (PD=-5.8%, 95% CI=-10.5, -1.1) women.
  
  
  CONCLUSIONS
  Four years after publication of USPSTF mammography recommendations, mammography prevalence for younger and older women did not significantly decrease except for higher-SES younger women. The significant decrease in physician recommendation of mammography in younger and older women may reflect a change in practice patterns by some physicians in response to USPSTF recommendations.
authors.affiliation: Intramural Research Department, American Cancer Society, Atlanta, Georgia; Department of Epidemiology, Emory University, Atlanta, Georgia. Electronic address: stacey.fedewa@cancer.org.
authors.forename: Stacey A
authors.initials: SA
authors.lastname: Fedewa
authors.affiliation: Healthcare Assessment Research Branch, National Cancer Institute, Bethesda, Maryland.
authors.forename: Janet S
authors.initials: JS
authors.lastname: de Moor
authors.affiliation: Intramural Research Department, American Cancer Society, Atlanta, Georgia.
authors.forename: Elizabeth M
authors.initials: EM
authors.lastname: Ward
authors.affiliation: Intramural Research Department, American Cancer Society, Atlanta, Georgia.
authors.forename: Carol E
authors.initials: CE
authors.lastname: DeSantis
authors.affiliation: Intramural Research Department, American Cancer Society, Atlanta, Georgia.
authors.forename: Ann
authors.initials: A
authors.lastname: Goding Sauer
authors.affiliation: Cancer Control Sciences, American Cancer Society, Atlanta, Georgia.
authors.forename: Robert A
authors.initials: RA
authors.lastname: Smith
authors.affiliation: Intramural Research Department, American Cancer Society, Atlanta, Georgia.
authors.forename: Ahmedin
authors.initials: A
authors.lastname: Jemal
mesh_terms: D000328:Adult; D026683:Advisory Committees; D000367:Age Factors; D000368:Aged; D001943:Breast Neoplasms / Q000175:diagnosis*; D003430:Cross-Sectional Studies; D005006:Ethnicity / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D007182:Income; D008327:Mammography / Q000706:statistics & numerical data*; D008403:Mass Screening / Q000379:methods*; D008875:Middle Aged; D010820:Physicians; D011795:Surveys and Questionnaires; D014481:United States