Mammography Screening Among the Elderly: A Research Challenge

Area of Science:

• Oncology
• Public Health
• Geriatric Medicine

Background:

• Mammography screening benefits are established for women up to age 74.
• Limited data exists on screening effectiveness in older women (69-84 years).
• Exploration of age- and race-specific screening rates and mortality is crucial.

Purpose of the Study:

• To investigate the association between mammography screening frequency and breast cancer mortality in elderly women.
• To analyze age- and race-specific differences in screening patterns and outcomes.
• To inform evidence-based guidelines for mammography screening in older populations.

Main Methods:

• Analysis of Medicare claims data (1995-2009) for 64,384 non-Hispanic women (black and white) aged 69-84.
• Inclusion of women diagnosed with breast cancer within Surveillance, Epidemiology and End Results (SEER) areas.
• Exposure defined as annual or biennial screening mammography in the 4 years prior to diagnosis; outcome as 10-year breast cancer mortality.

Main Results:

• Adjusted hazard ratios for 10-year breast cancer mortality were significantly lower for annual (0.31 for whites, 0.36 for blacks) and biennial (0.47 for both races) mammography compared to no/irregular screening.
• These mortality reductions were consistent across age strata (69-74, 75-78, 79-84 years).
• Similar trends were observed at 5-year follow-up and across both black and white women.

Conclusions:

• Elderly women (69-84) who self-selected for annual mammography screening experienced reduced 10-year breast cancer mortality.
• Findings were consistent between black and white women, underscoring the screening benefit across races.
• The study highlights potential limitations in current screening mammography recommendations for older adults.