Dongyu Zhang, Linn Abraham, Joshua Demb, Diana L Miglioretti, Shailesh Advani, Brian L Sprague, Louise M Henderson, Tracy Onega, Karen J Wernli, Louise C Walter, Karla Kerlikowske, John T Schousboe, Ellen S O'Meara, Dejana Braithwaite
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We estimated risk of breast cancer, breast cancer death, and non-breast cancer death by function-related indicator (FRI) which incorporated 16 claims-based items and was categorized as an ordinal variable (0, 1, and 2+). Fine and Gray proportional sub-distribution hazards models were applied with breast cancer and death treated as competing events. Risk estimates by FRI scores were adjusted by age and NCI comorbidity index separately and stratified by these factors.</p><p><strong>Results: </strong>Overall, 9,252 women were diagnosed with breast cancer, 406 died of breast cancer, and 41,640 died from non-breast cancer causes. The 10-year age-adjusted invasive breast cancer risk slightly decreased with FRI score [FRI = 0: 4.0%, 95% confidence interval (CI) = 3.8-4.1; FRI = 1: 3.9%, 95% CI = 3.7-4.2; FRI ≥ 2: 3.5%, 95% CI = 3.1-3.9). Risk of non-breast cancer death increased with FRI score (FRI = 0: 18.8%, 95% CI = 18.5-19.1; FRI = 1: 24.4%, 95% CI = 23.9-25.0; FRI ≥ 2: 39.8%, 95% CI = 38.8-40.9]. Risk of breast cancer death was low with minimal differences across FRI scores. NCI comorbidity index-adjusted models and stratified analyses yielded similar patterns.</p><p><strong>Conclusions: </strong>Risk of non-breast cancer death substantially increases with FRI score, whereas risk of breast cancer death is low regardless of functional status.</p><p><strong>Impact: </strong>Older women with functional limitations should be informed that they may not benefit from screening mammography.</p>","PeriodicalId":3,"journal":{"name":"ACS Applied Electronic Materials","volume":" ","pages":"1582-1590"},"PeriodicalIF":4.3000,"publicationDate":"2021-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8563300/pdf/nihms-1711028.pdf","citationCount":"2","resultStr":"{\"title\":\"Function-related Indicators and Outcomes of Screening Mammography in Older Women: Evidence from the Breast Cancer Surveillance Consortium Cohort.\",\"authors\":\"Dongyu Zhang, Linn Abraham, Joshua Demb, Diana L Miglioretti, Shailesh Advani, Brian L Sprague, Louise M Henderson, Tracy Onega, Karen J Wernli, Louise C Walter, Karla Kerlikowske, John T Schousboe, Ellen S O'Meara, Dejana Braithwaite\",\"doi\":\"10.1158/1055-9965.EPI-21-0152\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Previous reports suggested risk of death and breast cancer varied by comorbidity and age in older women undergoing mammography. 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引用次数: 2
摘要
背景:以前的报告表明，在接受乳房x光检查的老年妇女中，死亡和乳腺癌的风险因合并症和年龄而异。然而，功能限制的影响仍不清楚。方法:我们使用了乳腺癌监测联盟-医疗保险关联数据库(1999-2015)中238,849名年龄在66-94岁之间进行乳房x光筛查的女性的数据。我们通过功能相关指标(FRI)估计乳腺癌、乳腺癌死亡和非乳腺癌死亡的风险，FRI包括16个基于索赔的项目，并被归类为顺序变量(0、1和2+)。采用Fine和Gray比例亚分布风险模型，将乳腺癌和死亡视为竞争事件。FRI评分的风险估计分别根据年龄和NCI合并症指数进行调整，并根据这些因素进行分层。结果:总体而言，9252名女性被诊断患有乳腺癌，406人死于乳腺癌，41640人死于非乳腺癌原因。10年年龄调整后的浸润性乳腺癌风险随FRI评分略有下降[FRI = 0: 4.0%， 95%可信区间(CI) = 3.8-4.1;Fri = 1: 3.9%， 95% ci = 3.7 ~ 4.2;Fri≥2:3.5%，95% ci = 3.1 ~ 3.9)。非乳腺癌死亡风险随着FRI评分的增加而增加(FRI = 0: 18.8%， 95% CI = 18.5-19.1;Fri = 1: 24.4%， 95% ci = 23.9-25.0;Fri≥2:39.8%，95% ci = 38.8 ~ 40.9]。乳腺癌死亡风险较低，FRI评分差异极小。NCI共病指数调整模型和分层分析得出了类似的模式。结论:非乳腺癌死亡风险随FRI评分显著增加，而无论功能状态如何，乳腺癌死亡风险均较低。影响:应告知功能受限的老年妇女，她们可能无法从筛查性乳房x光检查中获益。
Function-related Indicators and Outcomes of Screening Mammography in Older Women: Evidence from the Breast Cancer Surveillance Consortium Cohort.
Background: Previous reports suggested risk of death and breast cancer varied by comorbidity and age in older women undergoing mammography. However, impacts of functional limitations remain unclear.
Methods: We used data from 238,849 women in the Breast Cancer Surveillance Consortium-Medicare linked database (1999-2015) who had screening mammogram at ages 66-94 years. We estimated risk of breast cancer, breast cancer death, and non-breast cancer death by function-related indicator (FRI) which incorporated 16 claims-based items and was categorized as an ordinal variable (0, 1, and 2+). Fine and Gray proportional sub-distribution hazards models were applied with breast cancer and death treated as competing events. Risk estimates by FRI scores were adjusted by age and NCI comorbidity index separately and stratified by these factors.
Results: Overall, 9,252 women were diagnosed with breast cancer, 406 died of breast cancer, and 41,640 died from non-breast cancer causes. The 10-year age-adjusted invasive breast cancer risk slightly decreased with FRI score [FRI = 0: 4.0%, 95% confidence interval (CI) = 3.8-4.1; FRI = 1: 3.9%, 95% CI = 3.7-4.2; FRI ≥ 2: 3.5%, 95% CI = 3.1-3.9). Risk of non-breast cancer death increased with FRI score (FRI = 0: 18.8%, 95% CI = 18.5-19.1; FRI = 1: 24.4%, 95% CI = 23.9-25.0; FRI ≥ 2: 39.8%, 95% CI = 38.8-40.9]. Risk of breast cancer death was low with minimal differences across FRI scores. NCI comorbidity index-adjusted models and stratified analyses yielded similar patterns.
Conclusions: Risk of non-breast cancer death substantially increases with FRI score, whereas risk of breast cancer death is low regardless of functional status.
Impact: Older women with functional limitations should be informed that they may not benefit from screening mammography.
期刊介绍：
ACS Applied Electronic Materials is an interdisciplinary journal publishing original research covering all aspects of electronic materials. The journal is devoted to reports of new and original experimental and theoretical research of an applied nature that integrate knowledge in the areas of materials science, engineering, optics, physics, and chemistry into important applications of electronic materials. Sample research topics that span the journal's scope are inorganic, organic, ionic and polymeric materials with properties that include conducting, semiconducting, superconducting, insulating, dielectric, magnetic, optoelectronic, piezoelectric, ferroelectric and thermoelectric.
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