Trends in Annual Surveillance Mammography Participation Among Breast Cancer Survivors From 2004 to 2016

Abstract

Background: Annual mammography is recommended for breast cancer survivors; however, population-level temporal trends in surveillance mammography participation have not been described. Our objective was to characterize trends in annual surveillance mammography participation among women with a personal history of breast cancer over a 13-year period. Methods: We examined annual surveillance mammography participation from 2004 to 2016 in a nationwide sample of commercially insured women with prior breast cancer. Rates were stratified by age group (40–49 vs 50–64 years), visit with a surgical/oncology specialist or primary care provider within the prior year, and sociodemographic characteristics. Joinpoint models were used to estimate annual percentage changes (APCs) in participation during the study period. Results: Among 141,672 women, mammography rates declined from 74.1% in 2004 to 67.1% in 2016. Rates were stable from 2004 to 2009 (APC, 0.1%; 95% CI, −0.5% to 0.8%) but declined 1.5% annually from 2009 to 2016 (95% CI, −1.9% to −1.1%). For women aged 40 to 49 years, rates declined 2.8% annually (95% CI, −3.4% to −2.1%) after 2009 versus 1.4% annually in women aged 50 to 64 years (95% CI, −1.9% to −1.0%). Similar trends were observed in women who had seen a surgeon/oncologist (APC, −1.7%; 95% CI, −2.1% to −1.4%) or a primary care provider (APC, −1.6%; 95% CI, −2.1% to −1.2%) in the prior year. Conclusions: Surveillance mammography participation among breast cancer survivors declined from 2009 to 2016, most notably among women aged 40 to 49 years. These findings highlight a need for focused efforts to improve adherence to surveillance and prevent delays in detection of breast cancer recurrence and second cancers.