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How does age affect baseline screening mammography performance measures? A decision model.
1Department of Radiology, John H. Stroger Jr. Hospital of Cook County, 1901 West Harrison Street, Chicago, IL 60612-9985, USA. jkeen@ccbhs.org
BMC Medical Informatics and Decision Making
|September 23, 2008
Summary
Screening mammography performance, including cancer detection and positive predictive values, significantly improves with age. This study models these age-dependent changes to aid informed medical decisions.
Area of Science:
- Radiology
- Oncology
- Biostatistics
Background:
- Informed medical decision-making for screening mammography requires understanding age-related performance metrics.
- A decision model was developed to predict age-specific outcomes for baseline mammograms.
Purpose of the Study:
- To model the age dependence of cancer detection rate, recall rate, and secondary performance measures for screening mammography.
- To compare baseline screening mammography with no screening.
Main Methods:
- A decision tree model was constructed for women aged 35-65 using Surveillance Epidemiology and End Results (SEER) data.
- Population-based estimates for mammography accuracy and diagnostic outcomes were utilized.
- Radiologist performance variability was incorporated into the model.
Main Results:
- Cancer detection rate increases with age (1.9/1000 at 40 to 15.1/1000 at 60).
- Positive predictive values for screening and diagnostic mammograms increase with age.
- Total intervention and positive biopsy fractions also increase with age.
Conclusions:
- Breast cancer prevalence and screening mammography performance measures significantly increase with age.
- The model provides age-specific data to support informed consumer decision-making regarding mammography screening.
