Department of Radiology, University of Washington, Seattle Cancer Care Alliance, Seattle, Washington.
Department of Population Medicine, Harvard Pilgrim Health Care Institute, Boston, Massachusetts.
J Natl Compr Canc Netw. 2022 Apr;20(4):379-386.e9. doi: 10.6004/jnccn.2021.7081.
Annual mammography is recommended for breast cancer survivors; however, population-level temporal trends in surveillance mammography participation have not been described. Our objective was to characterize trends in annual surveillance mammography participation among women with a personal history of breast cancer over a 13-year period.
We examined annual surveillance mammography participation from 2004 to 2016 in a nationwide sample of commercially insured women with prior breast cancer. Rates were stratified by age group (40-49 vs 50-64 years), visit with a surgical/oncology specialist or primary care provider within the prior year, and sociodemographic characteristics. Joinpoint models were used to estimate annual percentage changes (APCs) in participation during the study period.
Among 141,672 women, mammography rates declined from 74.1% in 2004 to 67.1% in 2016. Rates were stable from 2004 to 2009 (APC, 0.1%; 95% CI, -0.5% to 0.8%) but declined 1.5% annually from 2009 to 2016 (95% CI, -1.9% to -1.1%). For women aged 40 to 49 years, rates declined 2.8% annually (95% CI, -3.4% to -2.1%) after 2009 versus 1.4% annually in women aged 50 to 64 years (95% CI, -1.9% to -1.0%). Similar trends were observed in women who had seen a surgeon/oncologist (APC, -1.7%; 95% CI, -2.1% to -1.4%) or a primary care provider (APC, -1.6%; 95% CI, -2.1% to -1.2%) in the prior year.
Surveillance mammography participation among breast cancer survivors declined from 2009 to 2016, most notably among women aged 40 to 49 years. These findings highlight a need for focused efforts to improve adherence to surveillance and prevent delays in detection of breast cancer recurrence and second cancers.
乳腺癌幸存者建议每年进行乳房 X 光检查；然而，目前还没有描述人群水平监测乳房 X 光检查参与度的时间趋势。我们的目的是描述过去 13 年中患有乳腺癌的女性每年进行监测性乳房 X 光检查的趋势。
我们检查了 2004 年至 2016 年期间全国范围内有乳腺癌既往史的商业保险女性的年度监测性乳房 X 光检查的参与情况。根据年龄组（40-49 岁与 50-64 岁）、前一年是否看外科/肿瘤学专家或初级保健提供者以及社会人口统计学特征对这些数据进行分层。使用 Joinpoint 模型估计研究期间参与度的年百分比变化（APC）。
在 141672 名女性中，乳房 X 光检查率从 2004 年的 74.1%下降到 2016 年的 67.1%。2004 年至 2009 年期间，该比率保持稳定（APC，0.1%；95%CI，-0.5%至 0.8%），但 2009 年至 2016 年期间每年下降 1.5%（95%CI，-1.9%至-1.1%）。对于 40 至 49 岁的女性，与 50 至 64 岁的女性相比，在 2009 年之后每年下降 2.8%（95%CI，-3.4%至-2.1%），每年下降 1.4%（95%CI，-1.9%至-1.0%）。在过去一年中看过外科医生/肿瘤学家（APC，-1.7%；95%CI，-2.1%至-1.4%）或初级保健提供者（APC，-1.6%；95%CI，-2.1%至-1.2%）的女性中也观察到类似的趋势。
从 2009 年到 2016 年，乳腺癌幸存者的监测性乳房 X 光检查参与率下降，尤其是 40 至 49 岁的女性。这些发现突显了需要集中精力提高对监测的依从性，并防止乳腺癌复发和第二癌的检测延迟。
