124 lines
3.9 KiB
YAML
124 lines
3.9 KiB
YAML
abstract: 'BACKGROUND: Rural US women experience disparities in breast cancer
|
|
|
|
screening and outcomes. In 2006, a national rural health insurance
|
|
|
|
provider, the National Rural Electric Cooperative Association (NRECA),
|
|
|
|
eliminated out-of-pocket costs for screening mammography. METHODS: This
|
|
|
|
study evaluated the elimination of cost sharing as a natural experiment:
|
|
|
|
it compared trends in screening before and after the policy change.
|
|
|
|
NRECA insurance claims data were used to identify all women aged 40 to
|
|
|
|
64 years who were eligible for breast cancer screening, and mammography
|
|
|
|
utilization from 1998 through 2011 was evaluated. Repeated measures
|
|
|
|
regression models were used to evaluate changes in utilization over time
|
|
|
|
and the association between screening and sociodemographic factors.
|
|
|
|
RESULTS: The analysis was based on 45,738 women enrolled in the NRECA
|
|
|
|
membership database for an average of 6.1 years and included 279,940
|
|
|
|
person-years of enrollment. Between 1998 and 2011, the annual screening
|
|
|
|
rate increased from 35\% to a peak of 50\% among women aged 40 to 49
|
|
|
|
years and from 49\% to 58\% among women aged 50 to 64 years. The
|
|
|
|
biennial screening rate increased from 56\% to 66\% for women aged 40 to
|
|
|
|
49 years and from 68\% to 73\% for women aged 50 to 64 years. Screening
|
|
|
|
rates increased significantly (P < .0001) after the elimination of cost
|
|
|
|
sharing and then declined slightly after changes to government screening
|
|
|
|
guidelines in 2009. Younger women experienced greater increases in both
|
|
|
|
annual screening (6.2\%) and biennial screening (5.6\%) after the
|
|
|
|
elimination of cost sharing in comparison with older women (3.0\% and
|
|
|
|
2.6\%, respectively). In a multivariate analysis, rural residence, lower
|
|
|
|
population income, and lower population education were associated with
|
|
|
|
modestly lower screening. CONCLUSIONS: In a national sample of
|
|
|
|
predominantly rural working-age women, the elimination of cost sharing
|
|
|
|
correlated with increased breast cancer screening. (C) 2017 American
|
|
|
|
Cancer Society.'
|
|
affiliation: 'Peppercorn, J (Corresponding Author), Massachusetts Gen Hosp, Canc Survivorship
|
|
Program, 55 Fruit St, Boston, MA 02114 USA.
|
|
|
|
Peppercorn, Jeffrey; Horick, Nora; Rabin, Julia, Massachusetts Gen Hosp, Ctr Canc,
|
|
Boston, MA USA.
|
|
|
|
Houck, Kevin, Duke Univ, Med Ctr, Durham, NC USA.
|
|
|
|
Villagra, Victor, Univ Connecticut, Hlth Ctr, Farmington, CT USA.
|
|
|
|
Lyman, Gary H., Fred Hutchinson Canc Res Ctr, 1124 Columbia St, Seattle, WA 98104
|
|
USA.
|
|
|
|
Wheeler, Stephanie B., Univ N Carolina, Sch Global Publ Hlth, Chapel Hill, NC USA.'
|
|
author: Peppercorn, Jeffrey and Horick, Nora and Houck, Kevin and Rabin, Julia and
|
|
Villagra, Victor and Lyman, Gary H. and Wheeler, Stephanie B.
|
|
author-email: jpeppercorn@mgh.harvard.edu
|
|
author_list:
|
|
- family: Peppercorn
|
|
given: Jeffrey
|
|
- family: Horick
|
|
given: Nora
|
|
- family: Houck
|
|
given: Kevin
|
|
- family: Rabin
|
|
given: Julia
|
|
- family: Villagra
|
|
given: Victor
|
|
- family: Lyman
|
|
given: Gary H.
|
|
- family: Wheeler
|
|
given: Stephanie B.
|
|
da: '2023-09-28'
|
|
doi: 10.1002/cncr.30629
|
|
eissn: 1097-0142
|
|
files: []
|
|
issn: 0008-543X
|
|
journal: CANCER
|
|
keywords: 'access to care; breast cancer screening; disparities; health policy;
|
|
|
|
rural health'
|
|
keywords-plus: UNITED-STATES; TRENDS; RATES
|
|
language: English
|
|
month: JUL 1
|
|
number: '13'
|
|
number-of-cited-references: '26'
|
|
orcid-numbers: 'Lyman, Gary H/0000-0002-0823-8086
|
|
|
|
Horick, Nora/0000-0002-4355-5853'
|
|
pages: 2506-2515
|
|
papis_id: 5b79a2f7a6bba0c650096f49e1837175
|
|
ref: Peppercorn2017impactelimination
|
|
researcherid-numbers: 'Peppercorn, Jeffrey/GPX-3100-2022
|
|
|
|
Lyman, Gary H/K-5227-2019
|
|
|
|
'
|
|
times-cited: '8'
|
|
title: 'Impact of the Elimination of Cost Sharing for Mammographic Breast Cancer Screening
|
|
Among Rural US Women: A Natural Experiment'
|
|
type: article
|
|
unique-id: WOS:000403469500019
|
|
usage-count-last-180-days: '0'
|
|
usage-count-since-2013: '4'
|
|
volume: '123'
|
|
web-of-science-categories: Oncology
|
|
year: '2017'
|