ArticleMedical care2014
Potential overuse of screening mammography and its association with access to primary care.
Article in Medical care, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 26 papers, 4 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
26 citing papers in PubMed, 4 syntheses or guidelines pooled it.
- Antenatal screening practices in the WHO European Region: a mixed methods study.Journal of global health · 2020Pooled it
- Factors Influencing Overuse of Breast Cancer Screening: A Systematic Review.Journal of women's health (2002) · 2018Pooled it
- Overuse of Health Care Services in the Management of Cancer: A Systematic Review.Medical care · 2017Pooled it
- Guideline
- Patient Agency in Imaging: Radiologists' Insights.Public health challenges · 2025Article
- Development and internal validation of a new life expectancy estimator for multimorbid older adults.Diagnostic and prognostic research · 2025Article
- Understanding motivations of older women to continue or discontinue breast cancer screening.medRxiv : the preprint server for health sciences · 2025Article
- Understanding motivations of older women to continue or discontinue breast cancer screening.PloS one · 2025Article
- Physician perspectives regarding over-screening for breast, colorectal, and prostate cancers in older adults.Journal of the American Geriatrics Society · 2025Article
- Different Types of Patient Health Information Associated With Physician Decision-making Regarding Cancer Screening Cessation for Older Adults.JAMA network open · 2023Article
- Breast and Lung Cancer Screening Among Medicare Enrollees During the COVID-19 Pandemic.JAMA network open · 2023Article
- Comparison of Cancer-Related Spending and Mortality Rates in the US vs 21 High-Income Countries.JAMA health forum · 2022Article
- Factors Associated With Low-Value Cancer Screenings in the Veterans Health Administration.JAMA network open · 2021Article
- Association Between Receipt of Cancer Screening and All-Cause Mortality in Older Adults.JAMA network open · 2021Article
- Primary care provider perspectives on screening mammography in older women: A qualitative study.Preventive medicine reports · 2021Article
- Clinician Perspectives on Overscreening for Cancer in Older Adults With Limited Life Expectancy.Journal of the American Geriatrics Society · 2020Article
- Mammography use among women aged 18-39 years in the United States.Breast cancer research and treatment · 2018Article
- Evidence for overuse of medical services around the world.Lancet (London, England) · 2017Review
- Decision-Making Regarding Mammography Screening for Older Women.Journal of the American Geriatrics Society · 2016Article
- Screening Mammography Use Among Older Women Before and After the 2009 U.S. Preventive Services Task Force Recommendations.Journal of women's health (2002) · 2016Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
3 authors.
Funding
Abstract
backgroundCancer screening in individuals with limited life expectancy increases the risk of diagnosis and treatment of cancer that otherwise would not have become clinically apparent.
objectiveTo estimate screening mammography use in women with limited life expectancy, its geographic variation, and association with access to primary care and mammographic resources.
methodsWe assessed screening mammography use in 2008-2009 in 106,737 women aged 66 years or older with an estimated life expectancy of <7 years using a 5% national sample of Medicare beneficiaries. Descriptive statistics were used to estimate the screening mammography utilization, by access to primary care.
resultsAmong women with a life expectancy of <7 years, 28.5% received screening mammography during 2008-2009. The screening rates were 34.6% versus 20.5% for women with and without an identifiable primary care physician, respectively. The screening rates were higher among women who saw >1 generalist physician and who had more visits to generalist physicians. There was substantial geographic variation across the United States, with an average rate of 39.5% in the hospital referral regions (HRRs) in the top decile of screening versus 19.5% in the HRRs in the bottom decile. The screening rates were higher among HRRs with more primary care physicians (r=0.14, P=0.02), mammography facilities (r=0.12, P=0.04), and radiologists (r=0.22, P<0.001).
conclusionsSubstantial proportions of women with limited life expectancy receive screening mammography. Results presented sound a cautionary note that greater access to primary care and mammographic resources is also associated with higher overuse.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.