Short-Term Outcomes of Screening Mammography Using Computer-Aided Detection A Population-Based Study of Medicare Enrollees

被引:54
作者
Fenton, Joshua J.
Xing, Guibo
Elmore, Joann G.
Bang, Heejung
Chen, Steven L.
Lindfors, Karen K.
Baldwin, Laura-Mae
机构
[1] Univ Calif Davis, Ctr Healthcare Policy & Res, Sacramento, CA 95817 USA
[2] Univ Calif Davis, Ctr Comprehens Canc, Sacramento, CA 95817 USA
[3] City Hope Natl Med Ctr, Duarte, CA 91010 USA
[4] Univ Washington, Seattle, WA 98195 USA
关键词
BREAST-CANCER DETECTION; DIGITAL MAMMOGRAPHY; ASSISTED DETECTION; UNITED-STATES; PERFORMANCE; VALIDATION; IMPACT; CLAIMS; THERAPY; PROGRAM;
D O I
10.7326/0003-4819-158-8-201304160-00002
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Background: Computer-aided detection (CAD) has rapidly diffused into screening mammography practice despite limited and conflicting data on its clinical effect. 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. Design: Retrospective cohort study. Setting: Medicare program. 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). 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. 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]). Limitation: Short follow-up for cancer stage, potential unmeasured confounding, and uncertain generalizability to younger women. 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.
引用
收藏
页码:580 / +
页数:15
相关论文
共 42 条
[1]  
[Anonymous], AHRQ PUBLICATION
[2]   Advanced Breast Cancer and Breast Cancer Mortality in Randomized Controlled Trials on Mammography Screening [J].
Autier, Philippe ;
Hery, Clarisse ;
Haukka, Jari ;
Boniol, Mathieu ;
Byrnes, Graham .
JOURNAL OF CLINICAL ONCOLOGY, 2009, 27 (35) :5919-5923
[3]  
Baldwin LM, 2002, MED CARE, V40, P82
[4]   CAD systems for mammography: A real opportunity? A review of the literature [J].
Bazzocchi M. ;
Mazzarella F. ;
Del Frate C. ;
Girometti F. ;
Zuiani C. .
La radiologia medica, 2007, 112 (3) :329-353
[5]   Does computer-aided detection (CAD) contribute to the performance of digital mammography in a self-referred population? [J].
Brancato, Beniamino ;
Houssami, Nehmat ;
Francesca, Damiana ;
Bianchi, Simonetta ;
Risso, Gabriella ;
Catarzi, Sandra ;
Taschini, Renzo ;
Del Turco, Marco Rosselli ;
Ciatto, Stefano .
BREAST CANCER RESEARCH AND TREATMENT, 2008, 111 (02) :373-376
[6]   Systematic review: The long-term effects of false-positive mammograms [J].
Brewer, Noel T. ;
Salz, Talya ;
Lillie, Sarah E. .
ANNALS OF INTERNAL MEDICINE, 2007, 146 (07) :502-510
[7]  
Carney PA, 2003, ANN INTERN MED, V138, P168, DOI 10.7326/0003-4819-138-3-200302040-00008
[8]   Impact of computer-aided detection in a regional screening mammography program [J].
Cupples, TE ;
Cunningham, JE ;
Reynolds, JC .
AMERICAN JOURNAL OF ROENTGENOLOGY, 2005, 185 (04) :944-950
[9]   The relative contributions of screen-detected in situ and invasive breast carcinomas in reducing mortality from the disease [J].
Duffy, SW ;
Tabar, L ;
Vitak, B ;
Day, NE ;
Smith, RA ;
Chen, HHT ;
Yen, MFA .
EUROPEAN JOURNAL OF CANCER, 2003, 39 (12) :1755-1760
[10]  
Edge S.B., 2010, AJCC cancer staging manual, V649