Details:

Alternative Title:
Cancer Epidemiol Biomarkers Prev
Personal Author:
Berkowitz, Zahava ; Zhang, Xingyou ; Richards, Thomas B. ; Sabatino, Susan A. ; Peipins, Lucy A. ; ... More +
Berkowitz, Zahava ; Zhang, Xingyou ; Richards, Thomas B. ; Sabatino, Susan A. ; Peipins, Lucy A. ; Holt, James ; White, Mary C. Less -
Description:
Background:

The US Preventive Services Task Force recommends biennial screening mammography for average-risk women aged 50 to 74 years. County-level information on population measures of mammography use can inform targeted intervention to reduce geographic disparities in mammography use. County-level estimates for mammography use nationwide are rarely presented.

Methods:

We used data from the 2014 Behavioral Risk Factor Surveillance System (BRFSS) (n=130,289 women), linked it to the American Community Survey poverty data, and fitted multilevel logistic regression models with two outcomes: mammography within the past 2 years (up-to-date); and most recent mammography 5 or more years ago or never (rarely/never). We post-stratified the data with US Census population counts to run Monte Carlo simulations. We generated county-level estimates nationally and by urban-rural county classifications. County-level prevalence estimates were aggregated into state and national estimates. We validated internal consistency between our model-based state-specific estimates and urban-rural estimates with BRFSS direct estimates using Spearman correlation coefficients and mean absolute differences.

Results:

Correlation coefficients were 0.94 or larger. Mean absolute differences for the 2 outcomes ranged from 0.79 to 1.03. Although 78.45% (95% CI: 77.95%—78.92%) of women nationally were up-to-date with mammography, more than half of the states had counties with >15% of women rarely/never using a mammogram, many in rural areas.

Conclusions:

We provided estimates for all U.S. counties and identified marked variations in mammography use. Many states and counties were far from the 2020 target (81.1%).

Impact:

Our results suggest a need for planning and resource allocation on a local level to increase mammography uptake.


Subjects:
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Article County-level Estimates Internal Consistency Mammography Multilevel Small Area Estimation Rural Populations
Source:
Cancer Epidemiol Biomarkers Prev. 28(1):32-40
Pubmed ID:
30275116
Pubmed Central ID:
PMC6343124
Document Type:
Journal Article
Funding:
CC999999/ImCDC/Intramural CDC HHS/United States
Place as Subject:
United States
Collection(s):
CDC Public Access
Main Document Checksum:
[+]
urn:sha256:a123f9711739d204795467555c93b851bff7c716b7619a3df358a0a43e4292e9
Download URL:
https://stacks.cdc.gov/view/cdc/70139/cdc_70139_DS1.pdf
File Type:

Supporting Files

• 	nihms-1005270-f0001.gif	gif
  	nihms-1005270-f0001.jpg	jpeg
  	nihms-1005270.nxml	xml
  	NIHMS1005270-supplement-1.pdf	pdf
  	NIHMS1005270-supplement-2.pdf	pdf

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