• Am J Prev Med · Jul 2023

    Spillover After Mammography Guideline Change: Evidence From State-Level Trends.

    • Sarah A Nowak, Andrew D Wilcock, and Brian L Sprague.
    • Department of Pathology and Laboratory Medicine, Larner College of Medicine at the University of Vermont, Burlington, Vermont. Electronic address: Sarah.nowak@med.uvm.edu.
    • Am J Prev Med. 2023 Jul 1; 65 (1): 122125122-125.

    IntroductionChanges to which age groups are recommended for mammography may have affected screening rates for all women. This spillover effect has not previously been shown empirically in a national sample.MethodsUsing data from the Centers for Disease Control and Prevention's Behavioral Risk Factor Surveillance System from 2002 to 2018, authors tested whether screening trends at a national level changed after the 2009 U.S. Preventive Services Task Force guideline change. The authors also tested whether state-level screening trends for women aged 40-49 years and 75+ years were associated with screening trends for women aged 50-74 years. Analyses were conducted in March-December 2022.ResultsIn a model predicting state-level trends in screening for women aged 50-74 years, authors find positive, statistically significant associations with screening trends for women aged 40-49 years (p=0.033) and for women aged 75+ years (p<0.001).ConclusionsDeimplementation is difficult and important for controlling healthcare spending and delivering high value care. However, states most successful at reducing mammography screening rates among those aged 40-49 years and 75+ years also had greater reductions in recommended screening among women aged 50-74 years. More work is needed to understand and mitigate the unintended consequences of deimplementation.Copyright © 2023 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.

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