Trends in Mammography Usage Among Women Aged 30-44 in the United States From 2000-2018 Pubblico

Abstract

Technological innovation in breast cancer screening and interventions has led broad improvement in the morbidity and mortality. However, variations in professional guidelines, increasingly diverse patient populations, and an evolution of our understanding in risk underlie difficulties in providing individual guidance for when to begin breast cancer screening. Additionally, several past studies have demonstrated potential overuse of mammography among younger patient populations for whom there is limited benefit for the associated patient risk. Furthermore, there has been little investigation into rates of mammography usage in younger women over time. This analysis investigates study prevalence and trends in mammography usage in women aged 30-44 in the US from 2000 to 2018. Self-reported data from eight National Health Interview Surveys (NHIS) conducted between 2000-2018 was used to estimate the prevalence of ever having had a mammogram as well as having had a mammogram in the past year during each survey year. We observed significantly decreased adjusted prevalence rate ratios (aPRR) of ever having a mammogram among women aged 34- 39 during 2015 (0.456 95%CI: 0.407-0.511) and 2018 (0.408 95%CI:0.359-0.463) when compared with the same age group from 2000 (0.564 95%CI:0.525-0.605) and 2003 (0.580 95%CI: 0.539-0.624). This change is largely driven by year over year changes with significantly decreased utilization among non-Hispanic white women in 2010/2013 (0.784 95%CI: 0.709- 0.868) and 2015/2018 (0.619 95%CI: 0.548-0.698) when compared with the same group in 2000/2003. Our population analysis of NHIS US population survey data between 2000-2018 shows nationwide declines in mammogram utilization in women aged 30-39 with more mammography occurring in certain sub-populations with historically worse breast cancer outcomes.

Table of Contents

Introduction 1

Materials and Methods 3

Results 4

Discussion 7

Limitations 9

Conclusion 10

Figures 11

Table 1 11

Table 2 12

Table 3 13

Table 4 14

Tables 5 & 6 15

Tables 7 & 8 16

Table 9 & 10 17

Table 11 & 12 18

Figure 1 19

Figure 2 20

Citations 21

About this Master's Thesis

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School	Rollins School of Public Health
Department	Epidemiology
Subfield / Discipline	Epidemiology - MPH & MSPH
Degree	M.P.H.
Submission	Master's Thesis
Language	English
Research Field	Health Sciences, Epidemiology Health Sciences, Oncology Health Sciences, Public Health
Parola chiave	Mammography Survey analysis Breast Cancer Health Equity
Committee Chair / Thesis Advisor	Michael Goodman, Emory University
Committee Members	Stacey Fedewa, Emory University
Partnering Agencies	National or regional non-profit organization (e.g., American Cancer Society)

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