Changes in mammography screening in Ontario and Alberta following national guideline dissemination: an interrupted time series analysis.
| Autor: | Fahim C; Knowledge Translation Program, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, Ontario, M5B 1T8, Canada., Wiebe N; Department of Medicine, University of Alberta, Edmonton, Alberta, T6G 2G3, Canada., Nisenbaum R; MAP Centre for Urban Health Solutions, Li Ka Shing Knowledge Institute, Toronto, Ontario, M5B 1T8, Canada.; Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, M5T 3M7, Canada., Hamid JS; Department of Mathematics and Statistics, University of Ottawa, Ottawa, Ontario, K1N 6N5, Canada., Ewusie JE; Biostatistics Unit, Father Sean O'Sullivan Research Centre, Hamilton, Ontario, L8N 4A6, Canada., Tonelli M; Cumming School of Medicine, University of Calgary, Calgary, Alberta, T2N 1N4, Canada., Brauer P; Department of Family Relations and Applied Nutrition, University of Guelph, Guelph, Ontario, N1G 2W1, Canada., Shaw E; Department of Family Medicine, McMaster University, Hamilton, Ontario, L8S 4K1, Canada., Bell N; Department of Family Medicine, University of Alberta, Edmonton, Alberta, T6G 2R3, Canada., Stacey D; Faculty of Health Sciences, University of Ottawa, Ottawa, Ontario, K1N 6N5, Canada.; Ottawa Hospital Research Institute, Ottawa, Ontario, K1H 8L6, Canada., Holmes NM; Public Health Agency of Canada, Ottawa, Ontario, K1A 0K9, Canada., Straus SE; Knowledge Translation Program, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, Ontario, M5B 1T8, Canada.; Department of Medicine, University of Toronto, Toronto, Ontario, M5S 1A8, Canada. |
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| Jazyk: | angličtina |
| Zdroj: | F1000Research [F1000Res] 2021 Oct 15; Vol. 10, pp. 1044. Date of Electronic Publication: 2021 Oct 15 (Print Publication: 2021). |
| DOI: | 10.12688/f1000research.55004.2 |
| Abstrakt: | Background: In November 2011, the Canadian Task Force on Preventive Health Care released guidelines for screening women at average breast cancer risk. Weak recommendations (framed using GRADE methodology) were made for screening women aged 50 to 74 years every two to three years, and for not screening women aged 40 to 49 years. Methods: We conducted an interrupted time series analysis using administrative data to examine bilateral mammography use before and after a release of a national breast screening guideline. Women aged 40 to 74 years living in Ontario or Alberta from 30th November 2008 to 30th November 2014 were included. Strata included age, region of residence, neighbourhood income quintile, immigration status, and education level. Results: In both provinces, mammography use rates were lower in the post-intervention period (527 vs. 556 and 428 vs. 465/1000 women in Ontario and Alberta, respectively). In Ontario, mammography trends decreased following guideline release to align with recommendations for women aged 40 to 74 (decrease of 2.21/1000 women, SE 0.26/1000, p<0.0001). In Alberta, mammography trends decreased for women aged 40 to 49 years (3/1000 women, SE 0.32, p<0.001) and 50 to 69 (2.9/1000 women, SE 0.79, p<0.001), but did not change for women aged 70 to 74 (0.7/1000 women, SE 1.23, p=0.553). In both provinces, trends in mammography use rates were sustained for up to three years after guideline release. Conclusions: We observed a decrease in screening for women aged 40-49. Additional research to explore whether shared decision making was used to optimize guideline-concordant screening for women aged 50-74 is needed. Competing Interests: Competing interests: Drs. Tonelli, Brauer, Bell, and Shaw were members of the Canadian Task Force on Preventive Health Care. (Copyright: © 2022 Fahim C et al.) |
| Databáze: | MEDLINE |
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