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. 2013 Mar;61(3):388-95.
doi: 10.1111/jgs.12123. Epub 2013 Feb 15.

Targeting of mammography screening according to life expectancy in women aged 75 and older

Mara A Schonberg  1 , Erica S Breslau, Ellen P McCarthy
Affiliations

Targeting of mammography screening according to life expectancy in women aged 75 and older

Mara A Schonberg et al. J Am Geriatr Soc. 2013 Mar.

Abstract

Objectives: To examine receipt of mammography screening according to life expectancy in women aged 75 and older.

Design: Population-based survey.

Setting: United States.

Participants: Community dwelling U.S. women aged 75 and older who participated in the 2008 or 2010 National Health Interview Survey.

Measurements: Using a previously developed and validated index, women were categorized according to life expectancy (>9, 5-9, <5 years). Receipt of mammography screening in the past 2 years was examined according to life expectancy, adjusting for sociodemographic characteristics, access to care, preventive orientation (e.g., receipt of influenza vaccination), and receipt of a clinician recommendation for screening.

Results: Of 2,266 respondents, 27.1% had a life expectancy of greater than 9 years, 53.4% had a life expectancy of 5 to 9 years, and 19.5% had a life expectancy of less than 5 years. Overall, 55.7% reported receiving mammography screening in the past 2 years. Life expectancy was strongly associated with receipt of screening (P < .001), yet 36.1% of women with less than 5 years life expectancy were screened, and 29.2% of women with more than 9 years life expectancy were not screened. A clinician recommendation for screening was the strongest predictor of screening independent of life expectancy. Higher educational attainment, age, receipt of influenza vaccination, and history of benign breast biopsy were also independently associated with being screened.

Conclusion: Despite uncertainty of benefit, many women aged 75 and older are screened with mammography. Life expectancy is strongly associated with receipt of screening, which may reflect clinicians and patients appropriately considering life expectancy in screening decisions, but 36% of women with short life expectancies are still screened, suggesting that new interventions are needed to further improve targeting of screening according to life expectancy. Decision aids and guidelines encouraging clinicians to consider patient life expectancy in screening decisions may improve care.

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Conflict of interest statement

Conflict of Interest: The editor in chief has reviewed the conflict of interest checklist provided by the authors and has determined that the authors have no financial or any other kind of personal conflicts with this paper.

Figures

Figure 1
Figure 1
Study Sample
See this image and copyright information in PMC

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