Breast Cancer Screening in Patients With Newly Diagnosed Lung and Colorectal Cancer: A Population-Based Study of Utilization

• Type of Material: Article
• Authors: Gelareh Sadigh, Emory University; Ruth C. Carlos, University of Michigan; Kevin Ward, Emory University; Jeffrey Switchenko, Emory University; Renjian Jiang, Emory University; Kimberly Applegate, Emory University; Richard Duszak Jr, Emory University
• Language: English
• Date: 2017-03-19
• Publisher: Elsevier
• Publication Version: Author Accepted Manuscript (After Peer Review)
• Copyright Statement: © 2017 American College of Radiology
• Final Published Version (URL): http://dx.doi.org/10.1016/j.jacr.2017.01.022
• Title of Journal or Parent Work: Journal of the American College of Radiology
• ISSN: 1546-1440
• Volume: 14
• Issue: 7
• Start Page: 900
• End Page: 910
• Grant/Funding Information: Furthermore, this research was supported in part by the Biostatistics and Bioinformatics Shared Resource of Winship Cancer Institute of Emory University and National Institutes of Health/National Cancer Institute under award number P30CA138292.; Research reported in this publication was supported by the Radiological Society of North America Research and Education Foundation under award number RR1553.; This study used the linked Surveillance, Epidemiology, and End Results (SEER)-Medicare database.
• Keywords: Screening mammography; Science & Technology; TASK-FORCE RECOMMENDATIONS; population-based; DECISION-MAKING; SURVIVORS; 2ND PRIMARY CANCERS; MAMMOGRAPHY; cancer survivorship period; Life Sciences & Biomedicine; utilization; HEALTH BEHAVIOR CHANGES; UNITED-STATES; OLDER; CARE; Radiology, Nuclear Medicine & Medical Imaging; TRENDS
• Research Categories: Health Sciences, Public Health; Health Sciences, Radiology; Health Sciences, Epidemiology

Abstract

Purpose: To assess breast cancer screening utilization in Medicare beneficiaries with colorectal and lung cancer versus cancer-free controls. Methods: Female fee-for-service Medicare beneficiaries who were ≥67 years old and diagnosed with lung or colorectal cancer between 2000 and 2011 and who reported to a Surveillance, Epidemiology, and End Results (SEER) registry (case group) were followed for 2 years after their diagnoses, unless death, a diagnosis of breast cancer, or the end of 2013 came first. A similar number of cancer-free controls were individually matched to cases by age, race, registry region, and follow-up time. Screening utilization was defined as the percentage of women with ≥1 screening mammogram during follow-up. Results: Overall, 104,164 cases (48% colorectal, 52% lung; 30% advanced cancer) and 104,164 controls were included. Among women with lung or colorectal cancer, 22% underwent ≥1 screening mammogram versus 26% of controls (odds ratio [OR] 0.80; 95% confidence interval [CI] 0.78-0.82). Stratified by cancer type, 28% of colorectal cancer cases versus 29% of controls (OR 0.98; 95% CI 0.95-1.01) and 17% of lung cancer cases versus 23% of controls (OR 0.63; 95% CI 0.60-0.65) received ≥1 mammogram. When stratified by stage, 8% with advanced cancer versus 18% of controls (OR 0.33; 95% CI 0.31-0.35) and 30% with early-stage cancer versus 30% of controls (OR 1; 95% CI 0.97-1.02) underwent ≥1 mammogram. Conclusion: Screening mammography utilization rates are similar between Medicare beneficiaries with early-stage cancer versus controls. Although the majority of patients with advanced-stage cancer appropriately do not pursue screening mammography, a small number (8%) continue with screening.