The influence of health status, age, and race on screening mammography in elderly women.
Arch Intern Med
; 165(18): 2083-8, 2005 Oct 10.
Article
en En
| MEDLINE
| ID: mdl-16216997
ABSTRACT
BACKGROUND:
Screening mammography is controversial for elderly women because of an absence of efficacy data. Decisions to screen are based on individualized assessment of risks and benefits. Our objective was to determine how screening mammography varies by age and race when adjusted for propensity to die.METHODS:
In a retrospective cohort study, rates of screening mammogram performed in 2000-2001 based on claims, adjusted for propensity to die in 2000, were determined for a nationally representative 5% random sample of female fee-for-service Medicare beneficiaries 65 years and older in (N = 722,310).RESULTS:
The overall rate of screening was 39%. When stratified into quintiles by propensity to die, 2-year rates ranged from 61% in the lowest-risk group to 5% in the highest-risk group. In analyses stratified by age and adjusted for propensity to die, 42% of women aged 65 to 69 years were screened, declining to 26% of women 85 years and older (P<.001). Adjusted screening rates for white women, black women, and women of other races were 40%, 30%, and 25%, respectively (P<.001). Thus, among women with similar health status, the youngest women were 1.61 times more likely to be screened compared with the oldest; compared with black women and women of other races, white women were 1.38 and 1.60 times, respectively, more likely to be screened.CONCLUSIONS:
Decisions to screen for breast cancer are related not only to health status but also to age and race. Underuse and overuse of screening mammography likely occurs owing to age- and race-associated decision making. Assessment of life expectancy may more accurately identify women who could benefit from screening.
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Colección:
01-internacional
Base de datos:
MEDLINE
Asunto principal:
Neoplasias de la Mama
/
Mamografía
/
Tamizaje Masivo
/
Estado de Salud
/
Grupos Raciales
Tipo de estudio:
Diagnostic_studies
/
Etiology_studies
/
Incidence_studies
/
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
/
Screening_studies
Aspecto:
Determinantes_sociais_saude
/
Patient_preference
Límite:
Aged
/
Aged80
/
Female
/
Humans
País/Región como asunto:
America do norte
Idioma:
En
Revista:
Arch Intern Med
Año:
2005
Tipo del documento:
Article
País de afiliación:
Estados Unidos