MedicalResearch: What are the main findings of the study?
Dr. Tan: We found that substantial proportions of women with limited life expectancy receive screening mammography. The screening rates were higher among women who saw more than one generalist physician and who had more visits to generalist physicians. The screening rates were higher among U.S. hospital referral regions with more primary care physicians, mammography facilities and radiologists.
MedicalResearch: Were any of the findings unexpected?
Dr. Tan: Greater access to primary care is generally associated with higher quality of preventive and chronic care. However, we found that greater access to primary care was also associated with greater overuse of screening mammography.
MedicalResearch: What should clinicians and patients take away from your report?
Dr. Tan: Screening mammography in women with limited life expectancy would unlikely to provide any benefit but expose the women to greater risks of physical, emotional and economic suffering imposed by over-diagnosis and over-treatment.
MedicalResearch: What recommendations do you have for future research as a result of this study?
Dr. Tan: Continuing efforts are needed to reduce overuse, including improving awareness of screening harms, incorporating life expectancy in screening decision-making, and refining quality measures to include overuse indicators.