Change in Breast Cancer Screening Intervals Since the 2009 USPSTF Guideline.
Karen J Wernli, Robert F Arao, Rebecca A Hubbard, Brian L Sprague, Jennifer Alford-Teaster, Jennifer S Haas, Louise Henderson, Deidre Hill, Christoph I Lee, Anna N A Tosteson, Tracy Onega
Author Information
Karen J Wernli: 1 Group Health Research Institute , Seattle, Washington.
Robert F Arao: 1 Group Health Research Institute , Seattle, Washington.
Rebecca A Hubbard: 3 Department of Biostatistics and Epidemiology, University of Pennsylvania , Philadelphia, Pennsylvania.
Brian L Sprague: 4 Department of Surgery, Office of Health Promotion Research, and the University of Vermont Cancer Center, University of Vermont , Burlington, Vermont.
Jennifer Alford-Teaster: 5 The Dartmouth Institute for Health Policy and Clinical Practice , Geisel School of Medicine at Dartmouth, Lebanon , New Hampshire.
Jennifer S Haas: 7 Division of General Internal Medicine and Primary Care, Brigham and Women's Hospital, Boston, Massachusetts.
Louise Henderson: 9 Department of Radiology, University of North Carolina , Chapel Hill, North Carolina.
Deidre Hill: 10 University of New Mexico Cancer Center and School of Medicine, Albuquerque, New Mexico .
Christoph I Lee: 2 Department of Health Services, University of Washington School of Public Health , Seattle, Washington.
Anna N A Tosteson: 6 Departments of Biomedical Science and Epidemiology, Geisel School of Medicine at Dartmouth , Lebanon , New Hampshire.
Tracy Onega: 6 Departments of Biomedical Science and Epidemiology, Geisel School of Medicine at Dartmouth , Lebanon , New Hampshire.
BACKGROUND: In 2009, the U.S. Preventive Services Task Force (USPSTF) recommended biennial mammography for women aged 50-74 years and shared decision-making for women aged 40-49 years for breast cancer screening. We evaluated changes in mammography screening interval after the 2009 recommendations. MATERIALS AND METHODS: We conducted a prospective cohort study of women aged 40-74 years who received 821,052 screening mammograms between 2006 and 2012 using data from the Breast Cancer Surveillance Consortium. We compared changes in screening intervals and stratified intervals based on whether the mammogram at the end of the interval occurred before or after the 2009 recommendation. Differences in mean interval length by woman-level characteristics were compared using linear regression. RESULTS: The mean interval (in months) minimally decreased after the 2009 USPSTF recommendations. Among women aged 40-49 years, the mean interval decreased from 17.2 months to 17.1 months (difference -0.16%, 95% confidence interval [CI] -0.30 to -0.01). Similar small reductions were seen for most age groups. The largest change in interval length in the post-USPSTF period was declines among women with a first-degree family history of breast cancer (difference -0.68%, 95% CI -0.82 to -0.54) or a 5-year breast cancer risk ≥2.5% (difference -0.58%, 95% CI -0.73 to -0.44). CONCLUSIONS: The 2009 USPSTF recommendation did not lengthen the average mammography interval among women routinely participating in mammography screening. Future studies should evaluate whether breast cancer screening intervals lengthen toward biennial intervals following new national 2016 breast cancer screening recommendations, particularly among women less than 50 years of age.
