Change in Mammography Use Following the Revised Guidelines from the U.S. Preventive Services Task Force

Area of Science:

• Public Health
• Epidemiology
• Preventive Medicine

Background:

• The U.S. Preventive Services Task Force (USPSTF) revised mammography screening recommendations in 2009, altering guidelines for women aged 40-74.
• Previous recommendations advised biennial screening mammography for women 40 and older, while the 2009 update suggested biennial screening for women 50-74 and no routine screening for women 40-49.

Purpose of the Study:

• To evaluate the impact of the 2009 USPSTF guideline changes on mammography utilization.
• To compare mammography use trends before and after the revised recommendations, analyzing differences by race and age.

Main Methods:

• A cross-sectional study analyzed breast cancer risk factors from 2007 to 2013.
• 3442 participants enrolled after January 1, 2011, were matched by race, age, and education to participants enrolled between 2007-2010.
• Mammography use in the preceding two years was compared between the matched groups.

Main Results:

• White women aged 40-49 showed a 10.3% decrease (p < 0.001) and those aged 50-74 showed an 8.8% decrease (p < 0.001) in recent mammogram use.
• African-American women aged 40-49 and 50-74 did not exhibit statistically significant changes in mammogram use (-2.7%, p = 0.440 and -2.2%, p = 0.398, respectively).

Conclusions:

• The revised USPSTF guidelines were associated with a decline in mammography use among white women.
• Mammography screening rates among African-American women were not significantly affected by the guideline changes, suggesting potential disparities in guideline impact or adherence.