Advertisement

Cancer Causes & Control

, Volume 26, Issue 5, pp 723–732 | Cite as

Clinical outcomes of mammography in the National Breast and Cervical Cancer Early Detection Program, 2009–2012

  • Arica White
  • Jacqueline Miller
  • Janet Royalty
  • A. Blythe Ryerson
  • Vicki Benard
  • William Helsel
  • William Kammerer
Original paper

Abstract

Purpose

The National Breast and Cervical Cancer Early Detection Program (NBCCEDP) enrolls asymptomatic women for cancer screening and symptomatic women for diagnostic services. This study describes the results of mammograms provided by the NBCCEDP, by examination indication (screening or diagnostic), and by age group.

Methods

For the first NBCCEDP-funded mammogram received during 2009–2012, we calculated age-specific percentages of abnormal findings, rates of follow-up testing, and invasive and in situ breast cancer diagnoses per 1,000 mammograms. Logistic regression was used to estimate the odds for each of these outcomes by examination indication.

Results

The NBCCEDP provided 941,649 screening, 175,310 diagnostic, and 30,434 unknown indication mammograms to 1,147,393 women. The percentage with abnormal mammograms was higher for diagnostic mammograms (40.1 %) than for screening mammograms (15.5 %). Compared with women aged 40–49 years, fewer women aged 50–64 years had abnormal results for screening (13.7 vs. 19.7 %) and diagnostic mammograms (37.7 vs. 42.7 %). Follow-up rates per 1,000 mammograms were lower among women aged 50–64 compared to those aged 40–49 (screening: 143.9 vs. 207.5; diagnostic: 645.3 vs. 760.9); biopsy rates exhibited a similar pattern (screening: 24.1 vs. 32.9; diagnostic: 167.7 vs. 169.7). For screening mammograms, older women had more cancers detected than younger women (invasive: 3.6 vs. 2.2; in situ: 2.3 vs. 2.0). Similarly, for diagnostic mammograms, cancer detection was higher for older women (invasive: 67.8 vs. 36.6; in situ: 17.4 vs. 11.1).

Conclusions

Abnormal mammograms and diagnostic follow-up procedures were less frequent in women aged 50–64 years compared to women aged 40–49 years, while breast cancer detection was higher, regardless of indication for the mammogram. Some of these differences between age groups were greater for screening mammograms than for diagnostic mammograms. Cancer detection rates were higher for diagnostic mammograms compared with screening mammograms. These findings support the NBCCEDP’s priority of serving women aged 50–64 years and providing both screening and diagnostic mammograms.

Keywords

Breast cancer Mammography Screening 

Notes

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical standard

This study was approved by the Centers for Disease Control and Prevention Human Subjects Committee.

References

  1. 1.
    Ryerson AB, Benard VB, Major AC (2005) National Breast and Cervical Cancer Early Detection Program: 1991–2002 National Report. Atlanta: US Department of Health and Human Services, Center for Disease Control and PreventionGoogle Scholar
  2. 2.
    U. S. Preventive Services Task Force (2009) Screening for breast cancer: U.S. Preventive Services Task Force recommendation statement. Ann Intern Med 151:716–726 W-236CrossRefGoogle Scholar
  3. 3.
    Eheman CR, Benard VB, Blackman D et al (2006) Breast cancer screening among low-income or uninsured women: results from the National Breast and Cervical Cancer Early Detection Program, July 1995 to March 2002 (United States). Cancer Causes Control 17:29–38PubMedCrossRefGoogle Scholar
  4. 4.
    May DS, Lee NC, Nadel MR, Henson RM, Miller DS (1998) The National Breast and Cervical Cancer Early Detection Program: report on the first 4 years of mammography provided to medically underserved women. AJR Am J Roentgenol 170:97–104PubMedCrossRefGoogle Scholar
  5. 5.
    United States Department of Agriculture (2003) Economic research service measuring rurality: rural–urban continuum codesGoogle Scholar
  6. 6.
    United States Census Bureau (2013) Census Regions and Divisions of the United States. https://www.census.gov/geo/reference/gtc/gtc_census_divreg.html. Accessed 20 June 2014
  7. 7.
    D’Orsi CJME, Ikeda DM (2003) Breast imaging reporting and data system: ACR BI-RADS—breast imaging atlas. American College of Radiology, RestonGoogle Scholar
  8. 8.
    Lehman CD, White E, Peacock S, Drucker MJ, Urban N (1999) Effect of age and breast density on screening mammograms with false-positive findings. AJR Am J Roentgenol 173:1651–1655PubMedCrossRefGoogle Scholar
  9. 9.
    Howard D, Tangka F, Royalty J et al (2015) Breast cancer screening of underserved women in the USA: Results from the National Breast and Cervical Cancer Early Detection Program, 1998–2012. Cancer Causes Control. doi: 10.1007/s10552-015-0553-0

Copyright information

© Springer International Publishing Switzerland (outside the USA) 2015

Authors and Affiliations

  • Arica White
    • 1
  • Jacqueline Miller
    • 1
  • Janet Royalty
    • 1
  • A. Blythe Ryerson
    • 1
  • Vicki Benard
    • 1
  • William Helsel
    • 2
  • William Kammerer
    • 2
  1. 1.Division of Cancer Prevention and Control, National Center for Chronic Disease Prevention and Health PromotionCenters for Disease Control and PreventionAtlantaUSA
  2. 2.Information Management Services, Inc.CalvertonUSA

Personalised recommendations