Cargando…

Predictors of nonadherence to breast cancer screening guidelines in a United States urban comprehensive cancer center

BACKGROUND: This study aimed to identify predictors of nonadherence to breast cancer screening guidelines in an urban screening clinic among high‐ and average‐risk women in the United States. METHODS: We reviewed records of 6090 women who received ≥2 screening mammograms over 2 years at the Karmanos...

Descripción completa

Detalles Bibliográficos
Autores principales: Wehbe, Alexandra, Gonte, Madeleine R., O'Neill, Suzanne C., Amit‐Yousif, Alit, Purrington, Kristen, Manning, Mark, Simon, Michael S.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: John Wiley and Sons Inc. 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10417068/
https://www.ncbi.nlm.nih.gov/pubmed/37329206
http://dx.doi.org/10.1002/cam4.6182
_version_ 1785087932486385664
author Wehbe, Alexandra
Gonte, Madeleine R.
O'Neill, Suzanne C.
Amit‐Yousif, Alit
Purrington, Kristen
Manning, Mark
Simon, Michael S.
author_facet Wehbe, Alexandra
Gonte, Madeleine R.
O'Neill, Suzanne C.
Amit‐Yousif, Alit
Purrington, Kristen
Manning, Mark
Simon, Michael S.
author_sort Wehbe, Alexandra
collection PubMed
description BACKGROUND: This study aimed to identify predictors of nonadherence to breast cancer screening guidelines in an urban screening clinic among high‐ and average‐risk women in the United States. METHODS: We reviewed records of 6090 women who received ≥2 screening mammograms over 2 years at the Karmanos Cancer Institute to examine how breast cancer risk and breast density were associated with guideline‐concordant screening. Incongruent screening was defined as receiving supplemental imaging between screening mammograms for average‐risk women, and as not receiving recommended supplemental imaging for high‐risk women. We used t‐tests and chi‐square tests to examine bivariate associations with guideline‐congruent screening, and probit regression to regress guideline‐congruence unto breast cancer risk, breast density, and their interaction, controlling for age and race. RESULTS: Incongruent screening was more likely among high‐ versus average‐risk women (97.7% vs. 0.9%, p < 0.01). Among average‐risk women, incongruent screening was more likely among those with dense versus nondense breasts (2.0% vs. 0.1%, p < 0.01). Among high‐risk women, incongruent screening was more likely among those with nondense versus dense breasts (99.5% vs. 95.2%, p < 0.01). The significant main effects of density and high‐risk on increased incongruent screening were qualified by a density by high‐risk interaction, showing a weaker association between risk and incongruent screening among women with dense breasts (simple slope = 3.71, p < 0.01) versus nondense breasts (simple slope = 5.79, p < 0.01). Age and race were not associated with incongruent screening. CONCLUSIONS: Lack of adherence to evidence‐based screening guidelines has led to underutilization of supplementary imaging for high‐risk women and potential overutilization for women with dense breasts without other risk factors.
format Online
Article
Text
id pubmed-10417068
institution National Center for Biotechnology Information
language English
publishDate 2023
publisher John Wiley and Sons Inc.
record_format MEDLINE/PubMed
spelling pubmed-104170682023-08-12 Predictors of nonadherence to breast cancer screening guidelines in a United States urban comprehensive cancer center Wehbe, Alexandra Gonte, Madeleine R. O'Neill, Suzanne C. Amit‐Yousif, Alit Purrington, Kristen Manning, Mark Simon, Michael S. Cancer Med RESEARCH ARTICLES BACKGROUND: This study aimed to identify predictors of nonadherence to breast cancer screening guidelines in an urban screening clinic among high‐ and average‐risk women in the United States. METHODS: We reviewed records of 6090 women who received ≥2 screening mammograms over 2 years at the Karmanos Cancer Institute to examine how breast cancer risk and breast density were associated with guideline‐concordant screening. Incongruent screening was defined as receiving supplemental imaging between screening mammograms for average‐risk women, and as not receiving recommended supplemental imaging for high‐risk women. We used t‐tests and chi‐square tests to examine bivariate associations with guideline‐congruent screening, and probit regression to regress guideline‐congruence unto breast cancer risk, breast density, and their interaction, controlling for age and race. RESULTS: Incongruent screening was more likely among high‐ versus average‐risk women (97.7% vs. 0.9%, p < 0.01). Among average‐risk women, incongruent screening was more likely among those with dense versus nondense breasts (2.0% vs. 0.1%, p < 0.01). Among high‐risk women, incongruent screening was more likely among those with nondense versus dense breasts (99.5% vs. 95.2%, p < 0.01). The significant main effects of density and high‐risk on increased incongruent screening were qualified by a density by high‐risk interaction, showing a weaker association between risk and incongruent screening among women with dense breasts (simple slope = 3.71, p < 0.01) versus nondense breasts (simple slope = 5.79, p < 0.01). Age and race were not associated with incongruent screening. CONCLUSIONS: Lack of adherence to evidence‐based screening guidelines has led to underutilization of supplementary imaging for high‐risk women and potential overutilization for women with dense breasts without other risk factors. John Wiley and Sons Inc. 2023-06-17 /pmc/articles/PMC10417068/ /pubmed/37329206 http://dx.doi.org/10.1002/cam4.6182 Text en © 2023 The Authors. Cancer Medicine published by John Wiley & Sons Ltd. https://creativecommons.org/licenses/by/4.0/This is an open access article under the terms of the http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.
spellingShingle RESEARCH ARTICLES
Wehbe, Alexandra
Gonte, Madeleine R.
O'Neill, Suzanne C.
Amit‐Yousif, Alit
Purrington, Kristen
Manning, Mark
Simon, Michael S.
Predictors of nonadherence to breast cancer screening guidelines in a United States urban comprehensive cancer center
title Predictors of nonadherence to breast cancer screening guidelines in a United States urban comprehensive cancer center
title_full Predictors of nonadherence to breast cancer screening guidelines in a United States urban comprehensive cancer center
title_fullStr Predictors of nonadherence to breast cancer screening guidelines in a United States urban comprehensive cancer center
title_full_unstemmed Predictors of nonadherence to breast cancer screening guidelines in a United States urban comprehensive cancer center
title_short Predictors of nonadherence to breast cancer screening guidelines in a United States urban comprehensive cancer center
title_sort predictors of nonadherence to breast cancer screening guidelines in a united states urban comprehensive cancer center
topic RESEARCH ARTICLES
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10417068/
https://www.ncbi.nlm.nih.gov/pubmed/37329206
http://dx.doi.org/10.1002/cam4.6182
work_keys_str_mv AT wehbealexandra predictorsofnonadherencetobreastcancerscreeningguidelinesinaunitedstatesurbancomprehensivecancercenter
AT gontemadeleiner predictorsofnonadherencetobreastcancerscreeningguidelinesinaunitedstatesurbancomprehensivecancercenter
AT oneillsuzannec predictorsofnonadherencetobreastcancerscreeningguidelinesinaunitedstatesurbancomprehensivecancercenter
AT amityousifalit predictorsofnonadherencetobreastcancerscreeningguidelinesinaunitedstatesurbancomprehensivecancercenter
AT purringtonkristen predictorsofnonadherencetobreastcancerscreeningguidelinesinaunitedstatesurbancomprehensivecancercenter
AT manningmark predictorsofnonadherencetobreastcancerscreeningguidelinesinaunitedstatesurbancomprehensivecancercenter
AT simonmichaels predictorsofnonadherencetobreastcancerscreeningguidelinesinaunitedstatesurbancomprehensivecancercenter