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Short-term outcomes of screening mammography using computer-aided detection: a population-based study of medicare enrollees.
- Source :
-
Annals of internal medicine [Ann Intern Med] 2013 Apr 16; Vol. 158 (8), pp. 580-7. - Publication Year :
- 2013
-
Abstract
- Background: Computer-aided detection (CAD) has rapidly diffused into screening mammography practice despite limited and conflicting data on its clinical effect.<br />Objective: To determine associations between CAD use during screening mammography and the incidence of ductal carcinoma in situ (DCIS) and invasive breast cancer, invasive cancer stage, and diagnostic testing.<br />Design: Retrospective cohort study.<br />Setting: Medicare program.<br />Participants: Women aged 67 to 89 years having screening mammography between 2001 and 2006 in U.S. SEER (Surveillance, Epidemiology and End Results) regions (409 459 mammograms from 163 099 women).<br />Measurements: Incident DCIS and invasive breast cancer within 1 year after mammography, invasive cancer stage, and diagnostic testing within 90 days after screening among women without breast cancer.<br />Results: From 2001 to 2006, CAD prevalence increased from 3.6% to 60.5%. Use of CAD was associated with greater DCIS incidence (adjusted odds ratio [OR], 1.17 [95% CI, 1.11 to 1.23]) but no difference in invasive breast cancer incidence (adjusted OR, 1.00 [CI, 0.97 to 1.03]). Among women with invasive cancer, CAD was associated with greater likelihood of stage I to II versus III to IV cancer (adjusted OR, 1.27 [CI, 1.14 to 1.41]). In women without breast cancer, CAD was associated with increased odds of diagnostic mammography (adjusted OR, 1.28 [CI, 1.27 to 1.29]), breast ultrasonography (adjusted OR, 1.07 [CI, 1.06 to 1.09]), and breast biopsy (adjusted OR, 1.10 [CI, 1.08 to 1.12]).<br />Limitation: Short follow-up for cancer stage, potential unmeasured confounding, and uncertain generalizability to younger women.<br />Conclusion: Use of CAD during screening mammography among Medicare enrollees is associated with increased DCIS incidence, the diagnosis of invasive breast cancer at earlier stages, and increased diagnostic testing among women without breast cancer.<br />Primary Funding Source: Center for Healthcare Policy and Research, University of California, Davis.
- Subjects :
- Aged
Aged, 80 and over
Breast Neoplasms epidemiology
Breast Neoplasms pathology
Carcinoma, Intraductal, Noninfiltrating epidemiology
Carcinoma, Intraductal, Noninfiltrating pathology
Female
Humans
Incidence
Lymphatic Metastasis
Medicare
Neoplasm Staging
Outcome Assessment, Health Care
Retrospective Studies
SEER Program
United States epidemiology
Breast Neoplasms diagnostic imaging
Carcinoma, Intraductal, Noninfiltrating diagnostic imaging
Early Detection of Cancer methods
Mammography methods
Mass Screening methods
Radiographic Image Interpretation, Computer-Assisted
Subjects
Details
- Language :
- English
- ISSN :
- 1539-3704
- Volume :
- 158
- Issue :
- 8
- Database :
- MEDLINE
- Journal :
- Annals of internal medicine
- Publication Type :
- Academic Journal
- Accession number :
- 23588746
- Full Text :
- https://doi.org/10.7326/0003-4819-158-8-201304160-00002