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40至49岁参保女性乳房X光检查使用率的地区差异:美国预防服务工作组指南变更的影响

Regional variation in mammography use among insured women 40-49 years old: impact of a USPSTF guideline change.

作者信息

Hirth Jacqueline M, Kuo Yong-Fang, Lin Yu-Li, Berenson Abbey B

机构信息

Department of Obstetrics and Gynecology, University of Texas Medical Branch, 301 University Blvd Rte 0587, Galveston, TX 77555, .

Office of Biostatistics, Department of Preventive Medicine and Community Health, University of Texas Medical Branch, 301 University Blvd, Galveston, TX 77555.

出版信息

J Health Sci (El Monte). 2015 Apr;3(4):174-182. doi: 10.17265/2328-7136/2015.04.006. Epub 2015 Apr 30.

Abstract

PURPOSE

The impact of the US Preventive Services Task Force (USPSTF) recommendation that 40-49 year old women should no longer routinely receive screening mammography in November 2009 in different regions of the US is unknown.

METHODS

We conducted a retrospective cohort study using medical claims from administrative health records from privately insured 40-59 year old women enrolled between 2005 and 2012 to evaluate biennial screening trends.

RESULTS

There was a slight decrease in mammography usage among 40-49 year old US women after the 2008-2009 biennial period (p<0.001). There were some regional differences in mammography trends, with the West showing the greatest difference in odds of 40-49 year olds receiving a mammography in 2011-2012 compared to 2008-2009 (OR: 0.93; 95% CI: 0.91-0.94). Although trends for 50-59 year olds mirrored that of 40-49 year olds, the younger age group had a stronger decline in 2009-2010 and 2010-2011.

CONCLUSIONS

These findings show that USPSTF guideline changes made some differences in mammography usage among 40-49 year olds, but adherence was uneven across regions.

摘要

目的

2009年11月美国预防服务工作组(USPSTF)建议40至49岁女性不应再常规接受乳腺钼靶筛查,该建议在美国不同地区的影响尚不清楚。

方法

我们进行了一项回顾性队列研究,使用2005年至2012年期间参保的40至59岁女性行政健康记录中的医疗理赔数据来评估两年一次的筛查趋势。

结果

在2008 - 2009两年期之后,美国40至49岁女性的乳腺钼靶检查使用率略有下降(p<0.001)。乳腺钼靶检查趋势存在一些地区差异,与2008 - 2009年相比,西部地区在2011 - 2012年40至49岁女性接受乳腺钼靶检查的几率差异最大(OR:0.93;95%CI:0.91 - 0.94)。虽然50至59岁女性的趋势与40至49岁女性相似,但较年轻年龄组在2009 - 2010年和2010 - 2011年下降更为明显。

结论

这些发现表明,USPSTF指南的变化在40至49岁女性的乳腺钼靶检查使用方面产生了一些差异,但各地区的遵循情况并不一致。

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