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Research Studies is a compilation of published research articles funded by AHRQ or authored by AHRQ researchers.
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1 to 25 of 67 Research Studies DisplayedOffit LR, Chikarmane SA, Lacson RC
Frequency and outcomes of BI-RADS category 3 assessments in patients with a personal history of breast cancer: full-field digital mammography versus digital breast tomosynthesis.
The purpose of this article was to compare the frequency, outcomes, and additional characteristics of BI-RADS category 3 assessments between full-field digital mammography (FFDM) and digital breast tomosynthesis (DBT) in patients with a personal history of breast cancer (PHBC). This retrospective study examined electronic health records from 14,845 mammograms in 10,118 patients (mean age, 63 years) with PHBC who had undergone mastectomy and/or lumpectomy. Of these, 8422 examinations were performed by FFDM from October 2014 to October 2016 and the rest examinations by FFDM with DBT from February 2017 to December 2018. The frequency of category 3 assessment was lower for DBT than FFDM (5.6% vs 6.4%). DBT, compared with FFDM, showed a lower malignancy rate for category 3 lesions (1.8% vs 5.0%), higher malignancy rate for category 4 lesions (32.0% vs 23.2%), and no difference in malignancy rate for category 5 lesions (100.0% vs 75.0%). An analysis of index category 3 lesions included 438 lesions for FFDM and 274 lesions for DBT. For category 3 lesions, DBT, compared with FFDM, showed lower PPV3 (13.9% vs 36.1%) and a more frequent mammographic finding of mass (33.2% vs 23.1%).
AHRQ-funded; HS028616.
Citation: Offit LR, Chikarmane SA, Lacson RC .
Frequency and outcomes of BI-RADS category 3 assessments in patients with a personal history of breast cancer: full-field digital mammography versus digital breast tomosynthesis.
AJR Am J Roentgenol 2023 Sep; 221(3):313-22. doi: 10.2214/ajr.23.29067..
Keywords: Cancer: Breast Cancer, Cancer, Imaging, Women
Sprague BL, Ichikawa L, Eavey J
Breast cancer risk characteristics of women undergoing whole-breast ultrasound screening versus mammography alone.
This study evaluated mammography screening failure risk among women undergoing supplemental ultrasound screening in clinical practice in comparison with women undergoing mammography alone. Screening ultrasounds and screening mammograms without supplemental screening were identified within three Breast Cancer Surveillance Consortium registries. A clinically significant proportion of women who had undergone mammography screening alone were at high mammography screening failure risk. Ultrasound screening was highly targeted to women with dense breasts, but only a small proportion were high mammography screening failure risk.
AHRQ-funded; HS018366.
Citation: Sprague BL, Ichikawa L, Eavey J .
Breast cancer risk characteristics of women undergoing whole-breast ultrasound screening versus mammography alone.
Cancer 2023 Aug 15; 129(16):2456-68. doi: 10.1002/cncr.34768..
Keywords: Cancer: Breast Cancer, Cancer, Women, Imaging, Screening, Risk
Lee SJC, Lee J, Zhu H
Assessing barriers and facilitators to lung cancer screening: initial findings from a patient navigation intervention.
This study’s objective was to examine the challenges to providing lung cancer screening using low-dose computed tomography for patients, particularly minority, under-, and uninsured populations. The authors conducted a pragmatic randomized controlled trial of telephone-based navigation for lung cancer screening in an integrated, urban safety-net health care system. They used bilingual navigators (Spanish and English) to make systematic contact with patients, recording standardized call characteristics in a study-specific database. A total of 225 patients (mean age 63 years, 46% female, 70% racial/ethnic minority) were assigned navigators, with a total of 559 barriers to screening identified during 806 telephone calls. The most common barrier types were personal (46%), provider (30%), and practical (17%). System (6%) and psychosocial (1%) barriers were described by English-speaking patients, but not by Spanish-speaking patients. Provider-related barriers decreased by 80% over the course of the lung cancer screening process.
AHRQ-funded; HS022418.
Citation: Lee SJC, Lee J, Zhu H .
Assessing barriers and facilitators to lung cancer screening: initial findings from a patient navigation intervention.
Popul Health Manag 2023 Jun; 26(3):177-84. doi: 10.1089/pop.2023.0053..
Keywords: Cancer: Lung Cancer, Cancer, Screening, Prevention, Imaging
Lee CI, Abraham L, Miglioretti DL
National performance benchmarks for screening digital breast tomosynthesis: update from the Breast Cancer Surveillance Consortium.
The purpose of this study was to develop performance benchmarks for digital breast tomosynthesis (DBT) screening and assess longitudinal performance patterns in United States community practice. Between 2011 and 2018 the researchers collected DBT screening examinations from five Breast Cancer Surveillance Consortium (BCSC) registries. Measures of performance were calculated based on the American College of Radiology Breast Imaging Reporting and Data System, fifth edition and included abnormal interpretation rate (AIR), cancer detection rate (CDR), sensitivity, specificity, and false-negative rate (FNR). These rates were compared with previously published BCSC and National Mammography Database benchmarks, concurrent BCSC DM screening examinations, and expert opinion acceptable performance ranges. The study included a total of 896,101 women undergoing 2,301,766 screening examinations and 1,843,591 DM examinations were included in this study. All performance measures were higher for DBT except sensitivity and FNR, when compared with BCSC DM screening examinations from the same time period and previously published BCSC and National Mammography Database performance benchmarks. The following rates of radiologists received acceptable performance ranges with DBT: 97.6% for CDR, 91.8% for sensitivity, 75.0% for AIR, and 74.0% for specificity.
AHRQ-funded; HS018366.
Citation: Lee CI, Abraham L, Miglioretti DL .
National performance benchmarks for screening digital breast tomosynthesis: update from the Breast Cancer Surveillance Consortium.
Radiology 2023 May; 307(4):e222499. doi: 10.1148/radiol.222499..
Keywords: Cancer: Breast Cancer, Cancer, Screening, Imaging, Prevention, Women
Su YR, Buist DSM, Lee JM
Performance of statistical and machine learning risk prediction models for surveillance benefits and failures in breast cancer survivors.
The authors compared the relative predictive performance of statistical and machine learning (ML) models to guide modeling strategy selection for surveillance mammography outcomes in women with a personal history of breast cancer. They cross-validated seven risk prediction models for two surveillance outcomes, using 9,447 mammograms. The results suggested that regularized regression outperformed other modeling approaches for predicting breast cancer surveillance mammography outcomes and balanced the trade-off between model flexibility and interpretability.
AHRQ-funded; HS018366.
Citation: Su YR, Buist DSM, Lee JM .
Performance of statistical and machine learning risk prediction models for surveillance benefits and failures in breast cancer survivors.
Cancer Epidemiol Biomarkers Prev 2023 Apr 3; 32(4):561-71. doi: 10.1158/1055-9965.Epi-22-0677..
Keywords: Cancer: Breast Cancer, Cancer, Health Information Technology (HIT), Imaging
Wahid KA, Lin D, Sahin O
Large scale crowdsourced radiotherapy segmentations across a variety of cancer anatomic sites.
This article describes a data process in which over 200 expert and non-expert clinician annotators manually generated segmentations for regions of interest (ROIs) on computed tomography images across a variety of cancer sites for the Contouring Collaborative for Consensus in Radiation Oncology challenge. The author converted the data into Neuroimaging Informatics Technology Initiative format with standardized nomenclature for ease of use, and generated consensus segmentations using the Simultaneous Truth and Performance Level Estimation method. They conclude that these standardized, structured, and easily accessible data are a valuable resource for the systematic study of variability in segmentation applications, which is crucial for radiotherapy.
AHRQ-funded; HS026881.
Citation: Wahid KA, Lin D, Sahin O .
Large scale crowdsourced radiotherapy segmentations across a variety of cancer anatomic sites.
Sci Data 2023 Mar 22;10(1):161. doi: 10.1038/s41597-023-02062-w.
Keywords: Cancer, Imaging
Ho TH, Bissell MCS, Lee CI
Prioritizing screening mammograms for immediate interpretation and diagnostic evaluation on the basis of risk for recall.
The purpose of this study was to establish a prioritization method for immediate interpretation of screening mammograms and potential diagnostic assessment. A cohort based on the population, comprising screening mammograms conducted from 2012 to 2020 at 126 radiology centers from 7 Breast Cancer Surveillance Consortium registries, was examined. Classification trees were used to identify combinations of clinical history (age, BI-RADS density, time elapsed since the previous mammogram, history of false-positive recall or biopsy outcome), screening technique (digital mammography, digital breast tomosynthesis), and facility features (profit status, location, screening volume, practice type, academic affiliation) that grouped screening mammograms by recall rate, with ≥12/100 classified as high and ≥16/100 as very high. The efficiency ratio was calculated as the percentage of recalls divided by the percentage of mammograms. The research cohort consisted of 2,674,051 screening mammograms in 925,777 women, with 235,569 recalls. The study found that the primary predictor of recall was the time interval since the last mammogram, followed by age, history of false-positive recall, breast density, history of benign biopsy, and screening method. Recall rates were extremely high for baseline mammograms and high for women with ≥5 years since their previous mammogram. The 9.2% of mammograms in subgroups with very high and high recall rates represented 19.2% of recalls, yielding an efficiency ratio of 2.1 compared to a random strategy. Including women under 50 with dense breasts accounted for 20.3% of mammograms and 33.9% of recalls (efficiency ratio = 1.7). Findings incorporating facility-level characteristics were analogous.
AHRQ-funded; HS018366
Citation: Ho TH, Bissell MCS, Lee CI .
Prioritizing screening mammograms for immediate interpretation and diagnostic evaluation on the basis of risk for recall.
J Am Coll Radiol 2023 Mar;20(3):299-310. doi: 10.1016/j.jacr.2022.09.030.
Keywords: Cancer: Breast Cancer, Cancer, Screening, Imaging, Women, Prevention, Diagnostic Safety and Quality
Kim HS, Hernaez R, Sansgiry S
Comparative effectiveness of surveillance colonoscopy intervals on colorectal cancer outcomes in a national cohort of patients with inflammatory bowel disease.
The purpose of this study was to determine the comparative effectiveness of varying colonoscopy intervals on colorectal cancer (CRC) outcomes among patients with inflammatory bowel disease (IBD). Data was from the National Veterans Health Administration. Findings showed that, in a national cohort of patients with CRC-IBD, colonoscopy within 3 years prior to CRC diagnosis was associated with early tumor stage at diagnosis, and colonoscopy within 1 year was associated with a reduced all-cause mortality compared with no colonoscopy, supporting colonoscopy intervals of 1 to 3 years in patients with IBD in order to reduce late-stage CRC and all-cause mortality.
AHRQ-funded; HS024122.
Citation: Kim HS, Hernaez R, Sansgiry S .
Comparative effectiveness of surveillance colonoscopy intervals on colorectal cancer outcomes in a national cohort of patients with inflammatory bowel disease.
Clin Gastroenterol Hepatol 2022 Dec;20(12):2848-57.e2. doi: 10.1016/j.cgh.2022.02.048..
Keywords: Cancer: Colorectal Cancer, Cancer, Digestive Disease and Health, Imaging, Screening, Comparative Effectiveness, Evidence-Based Practice, Patient-Centered Outcomes Research
Wu A, Wu JY, Lim M
Updates in intraoperative strategies for enhancing intra-axial brain tumor control.
This review looked at recent advances in intraoperative strategies for enhancing intra-axial brain tumor control. The authors looked at published research centered on different innovative tools and techniques, including fluorescence-guided surgery, new methods of drug delivery, and minimally invasive procedural options.
AHRQ-funded; HS028747.
Citation: Wu A, Wu JY, Lim M .
Updates in intraoperative strategies for enhancing intra-axial brain tumor control.
Neuro Oncol 2022 Nov 2;24(suppl 6):S33-S41. doi: 10.1093/neuonc/noac170..
Keywords: Cancer, Surgery, Imaging
Ross RL, Rubio K, Rodriguez HP
Mammography and decision aid use for breast cancer screening in older women.
This study examines the association between practice-level decision-aid use and mammography use among older women. Physician practice responses to the 2017/2018 National Survey of Healthcare Organizations and Systems were linked to 2016-17 Medicare fee-for-service beneficiary data from eligible beneficiaries aged 65-74 years. Findings showed that health information technology-enabled automation of mammography reminders and other advanced health information technology functions may support mammography, whereas breast cancer decision aids may reduce patients' propensities to be screened through the alignment of their preferences and screening decision.
AHRQ-funded; HS022241; HS024075.
Citation: Ross RL, Rubio K, Rodriguez HP .
Mammography and decision aid use for breast cancer screening in older women.
Am J Prev Med 2022 Oct;63(4):630-35. doi: 10.1016/j.amepre.2022.04.014..
Keywords: Imaging, Screening, Decision Making, Cancer: Breast Cancer, Women, Prevention, Cancer, Elderly
Golmakani MK, Hubbard RA, Miglioretti DL
Nonhomogeneous Markov chain for estimating the cumulative risk of multiple false positive screening tests.
This study addressed the general challenge of estimating the cumulative risk of multiple false positive test results. The authors proposed a nonhomogeneous multistate model to describe the screening process including competing events and developed alternative approaches for estimating the cumulative risk of multiple false positive results using this multistate model based on existing estimators for the cumulative risk of a single false positive. The multistate model was based on existing estimators for the cumulative risk of a single false positive. They compared the performance of the newly proposed models through simulation studies and illustrated model performance using data on screening mammography from the Breast Cancer Surveillance Consortium. They found that in the context of screening mammography that the cumulative risk of multiple false positive results is high. For a high-risk individual, the cumulative probability of at least two false positive mammography results after 10 rounds of annual screening is 40.4.
AHRQ-funded; HS018366.
Citation: Golmakani MK, Hubbard RA, Miglioretti DL .
Nonhomogeneous Markov chain for estimating the cumulative risk of multiple false positive screening tests.
Biometrics 2022 Sep;78(3):1244-56. doi: 10.1111/biom.13484..
Keywords: Research Methodologies, Screening, Imaging, Cancer: Breast Cancer, Cancer
Kerlikowske K, Su YR, Sprague BL
Association of screening with digital breast tomosynthesis vs digital mammography with risk of interval invasive and advanced breast cancer.
The purpose of this study was to compare digital breast tomosynthesis (DBT) with digital mammography to determine whether DBT was correlated with lower rates of internal invasive cancer and advanced breast cancer, taking into consideration breast density and breast cancer risk. From 2011 through 2018, the researchers studied a cohort of 504,427 women between the ages of 40 and 79 who underwent 375,189 screening DBT exams and 1,003,900 screening digital mammography exams, and who were then followed up for cancer diagnoses between 2011 and 2019 after being identified via linkage to state or regional cancer registries. The median age at the time of screening was 58 years (IQR 50-65 years) and the diagnostic screenings took place at 44 Breast Cancer Surveillance Consortium (BCSC) facilities in the United States. The study found that among women at low to average risk, or at high risk with almost entirely fatty, scattered fibroglandular densities, or heterogeneously dense breasts, advanced cancer rates were not significantly different for DBT vs digital mammography. There was no significant difference between DBT and digital mammography for interval cancer rates per 1000 exams. Interval invasive cancer rates were also not significantly different among the 413,061 examinations with BCSC 5-year risk of 1.67% or higher (high risk) across breast density categories, or among all the 836,250 examinations with BCSC 5-year risk less than 1.67% (low to average-risk). For the 3.6% of women with extremely dense breasts and at high risk of breast cancer (13,291 examinations in the DBT group and 31,300 in the digital mammography group) advanced cancer rates per 1000 examinations were significantly lower for DBT vs digital mammography, but not for women at low to average risk (10,611 examinations in the DBT group and 37,796 in the digital mammography group). The researchers reported that there was no significant difference in the 96.4% of women with extremely dense breasts not at high risk, heterogeneously dense breasts, or nondense breasts, and concluded that screening with DBT vs digital mammography was associated with a significantly lower risk of advanced breast cancer among the 3.6% of women with extremely dense breasts and at high risk of breast cancer, and was not associated with a significant difference in risk of interval invasive cancer.
AHRQ-funded; HS018366.
Citation: Kerlikowske K, Su YR, Sprague BL .
Association of screening with digital breast tomosynthesis vs digital mammography with risk of interval invasive and advanced breast cancer.
JAMA 2022 Jun 14;327(22):2220-30. doi: 10.1001/jama.2022.7672..
Keywords: Cancer: Breast Cancer, Cancer, Screening, Women, Imaging, Risk
Tice JA, Gard CC, Miglioretti DL
Comparing mammographic density assessed by digital breast tomosynthesis or digital mammography: the Breast Cancer Surveillance Consortium.
This study’s purpose was to assess the consistency of Breast Imaging Reporting and Data System (BI-RADS) breast density reporting comparing digital breast tomosynthesis (DBT) with digital mammography (DM) and to evaluate density as a breast cancer risk factor when assessed using DM versus DBT. A secondary analysis of data from the Breast Cancer Surveillance Consortium was used from 342,149 women aged 40-79 years who underwent at least two screening mammography examinations less than 36 months apart. There were no significant differences in breast density assessment in pairs consisting of one DM and one DBT examination (57,516 of 74,729 [77%]), two DM examinations (238,678 of 301,743 [79%]), and two DBT examinations (20,763 of 26,854). Results were similar when pair analysis was restricted to readings by the same radiologist. The breast cancer hazard ratios (HRs) for breast density were similar for DM and DBT. The HRs for density acquired using DM and DBT, respectively, were 0.55 and 0.37 for almost entirely fat, 1.47 and 1.36 for heterogeneously dense, and 1.72 and 2.05 for extremely dense breasts.
AHRQ-funded; HS018366.
Citation: Tice JA, Gard CC, Miglioretti DL .
Comparing mammographic density assessed by digital breast tomosynthesis or digital mammography: the Breast Cancer Surveillance Consortium.
Radiology 2022 Feb; 302(2):286-92. doi: 10.1148/radiol.2021204579..
Keywords: Cancer: Breast Cancer, Cancer, Women, Imaging, Screening, Diagnostic Safety and Quality
Moazzezi M, Rose B, Kisling K
Prospects for daily online adaptive radiotherapy via ethos for prostate cancer patients without nodal involvement using unedited CBCT auto-segmentation.
This study’s objective was to assess the new online adaptive radiation therapy technology called Ethos for treating prostate cancer. Twenty-five prostate patients previously treated at the author’s clinic were re-planed using an Ethos emulator. Clinical margins of 3 mm posterior, 5 mm left/right/anterior, and 7 mm superior/inferior were used. Dose metrics were compared to unadapted plans to evaluate clinical target volumes (CTV) and online adaptive radiation (OAR) dose changes. Overall, 96% of fractions required auto-segmentation edits, although they were mostly minor. Adaptation improved CTV 98% for the 24 patients with minor auto-segmentation corrections. However, for one in 25 patients, large contour edits were required.
AHRQ-funded; HS025440.
Citation: Moazzezi M, Rose B, Kisling K .
Prospects for daily online adaptive radiotherapy via ethos for prostate cancer patients without nodal involvement using unedited CBCT auto-segmentation.
J Appl Clin Med Phys 2021 Oct;22(10):82-93. doi: 10.1002/acm2.13399..
Keywords: Cancer: Prostate Cancer, Cancer, Treatments, Imaging
Gerber DE, Hamann HA, Dorsey O
Clinician variation in ordering and completion of low-dose computed tomography for lung cancer screening in a safety-net medical system.
Less than 5% of eligible individuals in the United States undergo lung cancer screening. Variation in clinicians' participation in lung cancer screening has not been determined. In this study the investigators examined medical providers who ordered ≥ 1 low-dose computed tomography (LDCT) for lung cancer screening from February 2017 through February 2019 in an integrated safety-net healthcare system. The investigators concluded that in an integrated safety-net healthcare system, most adult primary care providers ordered LDCT.
AHRQ-funded; HS022418.
Citation: Gerber DE, Hamann HA, Dorsey O .
Clinician variation in ordering and completion of low-dose computed tomography for lung cancer screening in a safety-net medical system.
Clin Lung Cancer 2021 Jul;22(4):e612-e20. doi: 10.1016/j.cllc.2020.12.001..
Keywords: Imaging, Cancer: Lung Cancer, Cancer
Rauscher GH, Murphy AM, Qiu Q
The "sweet spot" revisited: optimal recall rates for cancer detection with 2D and 3D digital screening mammography in the Metro Chicago Breast Cancer Registry.
The authors examined the trade-offs for higher recall rates in terms of biopsy recommendations and cancer detection in mammography in a single large health care organization. 2D analog, 2D digital, and 3D digital mammography screenings among women 40-79 years old with cancer follow-up were examined. They found that the results of their investigation were in contrast to those of a recent study suggesting appropriateness of higher recall rates. They concluded that optimal cancer detection appeared to be in the recall rate range of 7-9% for both 2D digital mammography and 3D tomosynthesis.
AHRQ-funded; HS018366.
Citation: Rauscher GH, Murphy AM, Qiu Q .
The "sweet spot" revisited: optimal recall rates for cancer detection with 2D and 3D digital screening mammography in the Metro Chicago Breast Cancer Registry.
AJR Am J Roentgenol 2021 Apr;216(4):894-902. doi: 10.2214/ajr.19.22429.
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Keywords: Cancer: Breast Cancer, Cancer, Imaging, Screening, Diagnostic Safety and Quality, Women, Prevention
Meza R, Jeon J, Toumazis I
Evaluation of the benefits and harms of lung cancer screening with low-dose computed tomography: modeling study for the US Preventive Services Task Force.
The purpose of this study was to inform the USPSTF guidelines by estimating the benefits and harms associated with various low-dose computed tomography (LDCT) screening strategies. Microsimulation modeling studies suggested that LDCT screening for lung cancer compared with no screening may increase lung cancer deaths averted and life-years gained when optimally targeted and implemented. Screening individuals at aged 50 or 55 years through aged 80 years with 20 pack-years or more of smoking exposure was estimated to result in more benefits than the 2013 USPSTF-recommended criteria and less disparity in screening eligibility by sex and race/ethnicity.
AHRQ-funded; 290201500011I.
Citation: Meza R, Jeon J, Toumazis I .
Evaluation of the benefits and harms of lung cancer screening with low-dose computed tomography: modeling study for the US Preventive Services Task Force.
JAMA 2021 Mar 9;325(10):988-97. doi: 10.1001/jama.2021.1077..
Keywords: U.S. Preventive Services Task Force (USPSTF), Cancer: Lung Cancer, Cancer, Imaging, Screening, Prevention, Evidence-Based Practice, Guidelines
Jonas DE, Reuland DS, Reddy SM
Screening for lung cancer with low-dose computed tomography: updated evidence report and systematic review for the US Preventive Services Task Force.
The purpose of this study was to review the evidence on screening for lung cancer with low-dose computed tomography (LDCT) to inform the USPSTF. Findings showed that screening high-risk persons with LDCT can reduce lung cancer mortality but can also cause false-positive results leading to unnecessary tests and invasive procedures, overdiagnosis, incidental findings, increases in distress, and, rarely, radiation-induced cancers.
AHRQ-funded; 290201500011I.
Citation: Jonas DE, Reuland DS, Reddy SM .
Screening for lung cancer with low-dose computed tomography: updated evidence report and systematic review for the US Preventive Services Task Force.
JAMA 2021 Mar 9;325(10):971-87. doi: 10.1001/jama.2021.0377..
Keywords: U.S. Preventive Services Task Force (USPSTF), Cancer: Lung Cancer, Cancer, Imaging, Screening, Prevention, Evidence-Based Practice
Miglioretti DL, Bissell MCS, Kerlikowske K
Assessment of a risk-based approach for triaging mammography examinations during periods of reduced capacity.
Breast cancer screening, surveillance, and diagnostic imaging services were profoundly limited during the initial phase of the coronavirus disease 2019 (COVID-19) pandemic. The objective of this population-based cohort study was to develop a risk-based strategy for triaging mammograms during periods of decreased capacity. The investigators found that clinical indication and individual risk factors were associated with cancer detection and suggest these may be useful for prioritizing mammography in times and settings of decreased capacity.
AHRQ-funded; HS018366.
Citation: Miglioretti DL, Bissell MCS, Kerlikowske K .
Assessment of a risk-based approach for triaging mammography examinations during periods of reduced capacity.
JAMA Netw Open 2021 Mar;4(3):e211974. doi: 10.1001/jamanetworkopen.2021.1974..
Keywords: Screening, Cancer: Breast Cancer, Cancer, Women, Imaging, Access to Care, COVID-19
Lee CI, Zhu W, Onega T
Comparative access to and use of digital breast tomosynthesis screening by women's race/ethnicity and socioeconomic status.
This study looked at access to digital breast tomography (DBT) versus regular mammography and whether women of minority race/ethnicity and lower socioeconomic status experienced lower DBT access during the early adoption period and persistently lower DBT use over time. This cross-sectional study included 92 geographically diverse imaging facilities across 5 US states, with over 2.3 million screening examinations performed among women aged 40 to 89 years from January 1, 2011, to December 31, 2017. Data were analyzed from June 2019, to August 2020. Women who used DBT increased for all women from 3.3% in 2011 to 82.6% in 2017. In 2012, Black, Hispanic, Asian American, and women with less than a high school education had lower DBT access compared to White women attending the same facility and also college graduates. Lower DBT access continued over time regardless of the number of years after facility-level DBT adoption.
AHRQ-funded; HS018366.
Citation: Lee CI, Zhu W, Onega T .
Comparative access to and use of digital breast tomosynthesis screening by women's race/ethnicity and socioeconomic status.
JAMA Netw Open 2021 Feb;4(2):e2037546. doi: 10.1001/jamanetworkopen.2020.37546..
Keywords: Cancer: Breast Cancer, Cancer, Imaging, Access to Care, Women, Social Determinants of Health, Racial and Ethnic Minorities, Screening
Haymart MR, Reyes-Gastelum D, Caoili E
The relationship between imaging and thyroid cancer diagnosis and survival.
Controversy exists over whether there has been a true increase in the occurrence of thyroid cancer or overdiagnosis secondary to imaging practices. Because cancer overdiagnosis is associated with detection of indolent disease, overdiagnosis can be associated with perceived improvement in survival. The investigators concluded that there was improved disease-specific survival in patients diagnosed with thyroid cancer after thyroid ultrasound as compared with after other imaging.
AHRQ-funded; HS024512.
Citation: Haymart MR, Reyes-Gastelum D, Caoili E .
The relationship between imaging and thyroid cancer diagnosis and survival.
Oncologist 2020 Sep;25(9):765-71. doi: 10.1634/theoncologist.2020-0159..
Keywords: Cancer, Imaging, Diagnostic Safety and Quality
Arana-Chicas E, Kioumarsi A, Carroll-Scott A
Barriers and facilitators to mammography among women with intellectual disabilities: a qualitative approach.
The purpose of this qualitative study was to examine barriers and facilitators to mammography among women with intellectual disabilities. During 2015-2016 the researchers administered in-depth interviews with 30 women with intellectual disabilities and their caregivers in Philadelphia. The study found additional evidence supporting prior research on barriers to mammography among women with intellectual disabilities as well as novel barriers (e.g., lack of awareness of breast ultrasound, sedation failing to work, and lack of mammogram education) and novel facilitators (e.g., extended family support and positive attitudes.) The researchers concluded that the study results support the need to address barriers and focus on facilitators to improve the mammography experience in women with intellectual disabilities.
AHRQ-funded; HS023966.
Citation: Arana-Chicas E, Kioumarsi A, Carroll-Scott A .
Barriers and facilitators to mammography among women with intellectual disabilities: a qualitative approach.
Disabil Soc 2020;35(8):1290-314. doi: 10.1080/09687599.2019.1680348..
Keywords: Women, Disabilities, Vulnerable Populations, Screening, Prevention, Cancer: Breast Cancer, Cancer, Imaging
Sprague BL, Miglioretti DL, Lee CI
New mammography screening performance metrics based on the entire screening episode.
Established mammography screening performance metrics use the initial screening mammography assessment because they were developed for radiologist performance auditing, yet these metrics are frequently used to inform health policy and screening decision making. The authors developed new performance metrics based on the final assessment that consider the entire screening episode, including diagnostic workup. They concluded that established screening performance metrics underestimated the interval cancer rate of a mammography screening episode, particularly for women with dense breasts or an elevated breast cancer risk.
AHRQ-funded; HS018366.
Citation: Sprague BL, Miglioretti DL, Lee CI .
New mammography screening performance metrics based on the entire screening episode.
Cancer 2020 Jul 15;126(14):3289-96. doi: 10.1002/cncr.32939..
Keywords: Screening, Diagnostic Safety and Quality, Cancer: Breast Cancer, Cancer, Prevention, Women, Provider Performance, Imaging
Lowry KP, Coley RY, Miglioretti DL
Screening performance of digital breast tomosynthesis vs digital mammography in community practice by patient age, screening round, and breast density.
The purpose of this study was to compare digital mammography (DM) vs digital breast tomosynthesis (DBT) performance by age, baseline vs subsequent screening round, and breast density category. Information was taken from screening examinations at participating Breast Cancer Surveillance Consortium facilities of 1.5 million women aged 40 to 79 with no prior history of breast cancer. Findings showed that improvements in recall and cancer detection rates with DBT were greatest on baseline mammograms. On subsequent screening mammograms, the benefits of DBT varied by age and breast density, and women with extremely dense breasts did not benefit from improved recall or cancer detection with DBT on subsequent screening rounds.
AHRQ-funded; HS018366.
Citation: Lowry KP, Coley RY, Miglioretti DL .
Screening performance of digital breast tomosynthesis vs digital mammography in community practice by patient age, screening round, and breast density.
JAMA Netw Open 2020 Jul;3(7):e2011792. doi: 10.1001/jamanetworkopen.2020.11792..
Keywords: Imaging, Screening, Cancer: Breast Cancer, Cancer, Women, Evidence-Based Practice, Comparative Effectiveness, Diagnostic Safety and Quality
DiPiro PJ, Alper DP, Giess CS
Comparing breast and abdominal subspecialists' follow-up recommendations for incidental liver lesions on breast MRI.
This study compared breast and abdominal subspecialists’ follow-up recommendations following discovery of incidental liver lesions (ILLs) after breast MRI. When breast subspecialists recommended no follow-up abdominal subspecialists agreed with them in 29 out of 30 cases examined, but disagreed with 28 or 30 breast subspecialists’ follow-up recommendations. When breast imagers reported no ILLs, there was 93% agreement with abdominal subspecialists.
AHRQ-funded; HS024722.
Citation: DiPiro PJ, Alper DP, Giess CS .
Comparing breast and abdominal subspecialists' follow-up recommendations for incidental liver lesions on breast MRI.
J Am Coll Radiol 2020 Jun;17(6):773-78. doi: 10.1016/j.jacr.2019.12.024..
Keywords: Imaging, Diagnostic Safety and Quality, Screening, Cancer: Breast Cancer, Cancer, Women
