Journal article
Mammography adherence in relation to function-related indicators in older women
Preventive medicine, Vol.154, pp.106869-106869
01/2022
DOI: 10.1016/j.ypmed.2021.106869
PMCID: PMC8724400
PMID: 34762965
Abstract
Prior studies of screening mammography patterns by functional status in older women show inconsistent results. We used Breast Cancer Surveillance Consortium-Medicare linked data (1999–2014) to investigate the association of functional limitations with adherence to screening mammography in 145,478 women aged 66–74 years. Functional limitation was represented by a claims-based function-related indicator (FRI) score which incorporated 16 items reflecting functional status. Baseline adherence was defined as mammography utilization 9–30 months after the index screening mammography. Longitudinal adherence was examined among women adherent at baseline and defined as time from the index mammography to end of the first 30-month gap in mammography. Multivariable logistic regression and Cox proportional hazards models were used to investigate baseline and longitudinal adherence, respectively. Subgroup analyses were conducted by age (66–70 vs. 71–74 years). Overall, 69.6% of participants had no substantial functional limitation (FRI score 0), 23.5% had some substantial limitations (FRI score 1), and 6.8% had serious limitations (FRI score ≥ 2). Mean age at baseline was 68.5 years (SD = 2.6), 85.3% of participants were white, and 77.1% were adherent to screening mammography at baseline. Women with a higher FRI score were more likely to be non-adherent at baseline (FRI ≥ 2 vs. 0: aOR = 1.13, 95% CI = 1.06, 1.20, p-trend < 0.01). Similarly, a higher FRI score was associated with longitudinal non-adherence (FRI ≥ 2 vs. 0: aHR = 1.16, 95% CI = 1.11, 1.22, p-trend < 0.01). Effect measures of FRI did not differ substantially by age categories. Older women with a higher burden of functional limitations are less likely to be adherent to screening mammography recommendations.
•Functional limitations are common in older women eligible for screening mammography.•Women with functional limitations are less likely to undergo screening mammography.•The association of functional limitations exists after adjusting for comorbidities.
Details
- Title: Subtitle
- Mammography adherence in relation to function-related indicators in older women
- Creators
- Dongyu Zhang - Department of Epidemiology, University of Florida College of Public Health and Health Professions, Gainesville, FL, United States of AmericaLinn Abraham - Kaiser Permanente Washington Health Research Institute, Seattle, WA, United States of AmericaBrian L Sprague - Department of Surgery, University of Vermont College of Medicine, Burlington, VT, United States of AmericaTracy Onega - Department of Population Health Sciences and the Huntsman Cancer Institute, University of Utah, Salt Lake City, UT, United States of AmericaShailesh Advani - Department of Oncology, Georgetown University School of Medicine, Washington DC, United States of AmericaJoshua Demb - Division of Gastroenterology, Department of Internal Medicine, University of California, San Diego, La Jolla, CA, United States of AmericaDiana L Miglioretti - Kaiser Permanente Washington Health Research Institute, Seattle, WA, United States of AmericaLouise M Henderson - Department of Radiology, University of North Carolina at Chapel Hill, NC, United States of AmericaKaren J Wernli - Kaiser Permanente Washington Health Research Institute, Seattle, WA, United States of AmericaLouise C Walter - Department of Medicine, University of California, San Francisco, CA, United States of AmericaKarla Kerlikowske - Department of Medicine, University of California, San Francisco, CA, United States of AmericaJohn T Schousboe - Park Nicollet Clinic and HealthPartners Institute, HealthPartners Inc, Bloomington, MN, United States of AmericaElizabeth Chrischilles - Department of Epidemiology, College of Public Health, University of Iowa, Iowa City, IA, United States of AmericaDejana Braithwaite - Department of Epidemiology, University of Florida College of Public Health and Health Professions, Gainesville, FL, United States of AmericaEllen S O'Meara - Kaiser Permanente Washington Health Research Institute, Seattle, WA, United States of AmericaBreast Cancer Surveillance Consortium
- Resource Type
- Journal article
- Publication Details
- Preventive medicine, Vol.154, pp.106869-106869
- DOI
- 10.1016/j.ypmed.2021.106869
- PMID
- 34762965
- PMCID
- PMC8724400
- NLM abbreviation
- Prev Med
- ISSN
- 0091-7435
- eISSN
- 1096-0260
- Publisher
- Elsevier Inc
- Grant note
- DOI: 10.13039/100000054, name: NCI; DOI: 10.13039/100006093, name: PCORI
- Language
- English
- Date published
- 01/2022
- Academic Unit
- Pharmacy; Epidemiology
- Record Identifier
- 9984214810202771
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