[ { "phenotype_id": "PH388", "phenotype_version_id": 776, "name": "Screen Breast", "definition": "Aims/hypothesis: \n\nStudies from healthcare databases suggest that patients with type 2 diabetes (T2D) under-utilize cancer screening opportunities, but recording bias may be a problem. We evaluated the relative effect of T2D on screening utilization trends among long-established UK national programmes in breast and cervical cancers; and tested the impact of introducing a primary care financial incentive scheme (QOF) in 2004, known to improve data recording for diabetes-related care.\n\n\nMaterials and methods: \n\nUsing the Clinical Practice Research Datalink, we identified women with prevalent T2DM (N = 174,256), separately by year for 1999 to 2011, and eligible for screening events for breast (aged 50-70 years) and cervical (aged 35-49 and 50-64 years) cancers. We described secular trends and compared these with the non-diabetes population, and accounted for co-morbidities using matched conditional logistic regression models. We performed interrupted time-series (ITS) analyses to assess the impact of the QOF introduction.\n\n\nResults: \n\nCompared with the non-diabetes population, relative uptake rates for breast and cervical screening were generally similar in patients with T2D pre-2004, becoming greater for years post-2004. These patterns were unaffected by adjustment for GP practice, and were not accounted for by T2D associated co-morbidities. ITS analysis showed increased activities in all three screening groups for 2007, but these broadly returned to pre-2004 trends by 2011, paralleling similar patterns in recording for other care provision indicators.\n\n\nConclusions/interpretation: \n\nIn this population, we found no evidence that women with T2D under-utilize breast and cervical cancer screening opportunities. A financial incentive scheme was associated with intermediate-term improvements in screening utilization, but this is likely to reflect improved recording of care events.\n\n\n\n\n\n\n\n\n", "implementation": "", "publications": [ { "doi": null, "details": "Magthew Carr, Even Kontopantelis, Tim Doran, Christian Campbell, Lorraine Lipscombe, Emma Crosbie, Anthony Howell, Iain E Buchan, Andrew G Renehan, Breast and Cervical Cancer Screening Utilization, and recording bias, in women with type 2 diabetes (UK). 2015." } ], "validation": "", "citation_requirements": "", "created": "2021-10-06T16:16:58.736521Z", "author": "Matthew Carr, Evan Kontopantelis, Tim Doran, Christine Campbell, Lorraine Lipscombe, Emma Crosbie, Anothony Howell, Iain E Buchan, Andrew G Renehan", "collections": [ { "name": "ClinicalCodes Repository", "value": 25 }, { "name": "Phenotype Library", "value": 18 } ], "tags": null, "organisation": null, "world_access": 1, "updated": "2021-10-06T16:16:58.736551Z", "sex": [ { "name": "Female", "value": "2" } ], "type": [ { "name": "Biomarker", "value": "1" } ], "ontology": null, "phenoflowid": "", "data_sources": [ { "name": "CPRD GOLD", "value": 5, "uid": "a29feafa-7bdd-44e9-b977-c9d26425e67f", "url": "https://healthdatagateway.org/en/dataset/694", "datasource_id": 694 } ], "coding_system": [ { "name": "Read codes v2", "value": 5 }, { "name": "OXMIS codes", "value": 15 } ], "event_date_range": "1999 - 2011", "concept_information": [ { "concept_id": 1718, "concept_version_id": 4574, "concept_name": "Screen Breast - Primary Care", "coding_system": { "id": 5, "name": "Read codes v2", "description": "Read codes v2" }, "phenotype_id": "PH388", "phenotype_version_id": 776, "phenotype_name": "Screen Breast", "code_attribute_header": [ "Entity type", "Coding System (OXMIS Read)", "Category" ], "codes": [ { "code": "1A81.00", "description": "No breast lump", "attributes": { "Entity type": "res22: screen_breast", "Coding System (OXMIS Read)": "Read", "Category": "test" } }, { "code": "1A82.00", "description": "Breast lump present", "attributes": { "Entity type": "res22: screen_breast", "Coding System (OXMIS Read)": "Read", "Category": "test" } }, { "code": "1A84.00", "description": "Breast lump detected by mammogram", "attributes": { "Entity type": "res22: screen_breast", "Coding System (OXMIS Read)": "Read", "Category": "test" } }, { "code": "537..00", "description": "Soft tissue X-ray breast", "attributes": { "Entity type": "res22: screen_breast", "Coding System (OXMIS Read)": "Read", "Category": "test" } }, { "code": "5371.00", "description": "Mammography requested", "attributes": { "Entity type": "res22: screen_breast", "Coding System (OXMIS Read)": "Read", "Category": "test" } }, { "code": "537..11", "description": "Mammography - X-ray", "attributes": { "Entity type": "res22: screen_breast", "Coding System (OXMIS Read)": "Read", "Category": "test" } }, { "code": "5372.00", "description": "Mammography normal", "attributes": { "Entity type": "res22: screen_breast", "Coding System (OXMIS Read)": "Read", "Category": "test" } }, { "code": "5373.00", "description": "Mammography abnormal", "attributes": { "Entity type": "res22: screen_breast", "Coding System (OXMIS Read)": "Read", "Category": "test" } }, { "code": "5374.00", "description": "Mammography offered", "attributes": { "Entity type": "res22: screen_breast", "Coding System (OXMIS Read)": "Read", "Category": "test" } }, { "code": "5376.00", "description": "Mammography attended", "attributes": { "Entity type": "res22: screen_breast", "Coding System (OXMIS Read)": "Read", "Category": "test" } }, { "code": "537Z.00", "description": "Soft tissue X-ray breast NOS", "attributes": { "Entity type": "res22: screen_breast", "Coding System (OXMIS Read)": "Read", "Category": "test" } }, { "code": "54L3.00", "description": "Mammary gland contrast radiog.", "attributes": { "Entity type": "res22: screen_breast", "Coding System (OXMIS Read)": "Read", "Category": "test" } }, { "code": "54L3.11", "description": "Breast contrast radiog", "attributes": { "Entity type": "res22: screen_breast", "Coding System (OXMIS Read)": "Read", "Category": "test" } }, { "code": "54L3.12", "description": "Mammary contrast radiog", "attributes": { "Entity type": "res22: screen_breast", "Coding System (OXMIS Read)": "Read", "Category": "test" } }, { "code": "56B1.00", "description": "Specific mammary gland imaging", "attributes": { "Entity type": "res22: screen_breast", "Coding System (OXMIS Read)": "Read", "Category": "test" } }, { "code": "585C.00", "description": "US scan of breast", "attributes": { "Entity type": "res22: screen_breast", "Coding System (OXMIS Read)": "Read", "Category": "test" } }, { "code": "5861.00", "description": "Thermography - breast", "attributes": { "Entity type": "res22: screen_breast", "Coding System (OXMIS Read)": "Read", "Category": "test" } }, { "code": "5861.11", "description": "Mammogram-thermographic", "attributes": { "Entity type": "res22: screen_breast", "Coding System (OXMIS Read)": "Read", "Category": "test" } }, { "code": "6862.00", "description": "Breast neoplasm screen", "attributes": { "Entity type": "res22: screen_breast", "Coding System (OXMIS Read)": "Read", "Category": "test" } }, { "code": "6862000", "description": "Breast neoplasm screen normal", "attributes": { "Entity type": "res22: screen_breast", "Coding System (OXMIS Read)": "Read", "Category": "test" } }, { "code": "6862100", "description": "Breast neoplasm screen abnorm", "attributes": { "Entity type": "res22: screen_breast", "Coding System (OXMIS Read)": "Read", "Category": "test" } }, { "code": "6862.11", "description": "Mammography - screening", "attributes": { "Entity type": "res22: screen_breast", "Coding System (OXMIS Read)": "Read", "Category": "test" } }, { "code": "6862Z00", "description": "Breast neoplasm screen NOS", "attributes": { "Entity type": "res22: screen_breast", "Coding System (OXMIS Read)": "Read", "Category": "test" } }, { "code": "6865.00", "description": "Breast neoplasm screen normal", "attributes": { "Entity type": "res22: screen_breast", "Coding System (OXMIS Read)": "Read", "Category": "test" } }, { "code": "7P0F.00", "description": "Diagnostic imaging of breast", "attributes": { "Entity type": "res22: screen_breast", "Coding System (OXMIS Read)": "Read", "Category": "test" } }, { "code": "7P0F000", "description": "Scintimammography", "attributes": { "Entity type": "res22: screen_breast", "Coding System (OXMIS Read)": "Read", "Category": "test" } }, { "code": "7P0F100", "description": "Thermography of breast", "attributes": { "Entity type": "res22: screen_breast", "Coding System (OXMIS Read)": "Read", "Category": "test" } }, { "code": "7P0F200", "description": "Mammography", "attributes": { "Entity type": "res22: screen_breast", "Coding System (OXMIS Read)": "Read", "Category": "test" } }, { "code": "7P0Fy00", "description": "Other specified diagnostic imaging of breast", "attributes": { "Entity type": "res22: screen_breast", "Coding System (OXMIS Read)": "Read", "Category": "test" } }, { "code": "7P0Fz00", "description": "Diagnostic imaging of breast NOS", "attributes": { "Entity type": "res22: screen_breast", "Coding System (OXMIS Read)": "Read", "Category": "test" } }, { "code": "8HT8.00", "description": "Referral to mammography clinic", "attributes": { "Entity type": "res22: screen_breast", "Coding System (OXMIS Read)": "Read", "Category": "test" } }, { "code": "8HTI.00", "description": "Referral to breast clinic", "attributes": { "Entity type": "res22: screen_breast", "Coding System (OXMIS Read)": "Read", "Category": "test" } }, { "code": "9N0A.00", "description": "Seen in breast clinic", "attributes": { "Entity type": "res22: screen_breast", "Coding System (OXMIS Read)": "Read", "Category": "test" } }, { "code": "9N1y900", "description": "Seen in breast clinic", "attributes": { "Entity type": "res22: screen_breast", "Coding System (OXMIS Read)": "Read", "Category": "test" } }, { "code": "9Np2.00", "description": "Seen in fast track suspected breast cancer clinic", "attributes": { "Entity type": "res22: screen_breast", "Coding System (OXMIS Read)": "Read", "Category": "test" } }, { "code": "9OH9.00", "description": "Breast screen abnorm.-told pat", "attributes": { "Entity type": "res22: screen_breast", "Coding System (OXMIS Read)": "Read", "Category": "test" } }, { "code": "9OHZ.00", "description": "Breast screening administr.NOS", "attributes": { "Entity type": "res22: screen_breast", "Coding System (OXMIS Read)": "Read", "Category": "test" } }, { "code": "9Oq8.00", "description": "Attended breast screening clinic", "attributes": { "Entity type": "res22: screen_breast", "Coding System (OXMIS Read)": "Read", "Category": "test" } }, { "code": "R138.00", "description": "[D]Breast imaging abnormal", "attributes": { "Entity type": "res22: screen_breast", "Coding System (OXMIS Read)": "Read", "Category": "test" } }, { "code": "R138000", "description": "[D]Mammogram abnormal", "attributes": { "Entity type": "res22: screen_breast", "Coding System (OXMIS Read)": "Read", "Category": "test" } }, { "code": "R138z00", "description": "[D]Breast imaging abnormal NOS", "attributes": { "Entity type": "res22: screen_breast", "Coding System (OXMIS Read)": "Read", "Category": "test" } }, { "code": "ZV76100", "description": "[V]Screening for malignant neoplasm of breast", "attributes": { "Entity type": "res22: screen_breast", "Coding System (OXMIS Read)": "Read", "Category": "test" } } ] }, { "concept_id": 1719, "concept_version_id": 4576, "concept_name": "Screen Breast - Primary Care", "coding_system": { "id": 15, "name": "OXMIS codes", "description": "OXMIS codes" }, "phenotype_id": "PH388", "phenotype_version_id": 776, "phenotype_name": "Screen Breast", "code_attribute_header": [ "Entity type", "Coding System (OXMIS Read)", "Category" ], "codes": [ { "code": "L0010CB", "description": "SEEN IN MAMMOGRAPHY CLINIC", "attributes": { "Entity type": "res22: screen_breast", "Coding System (OXMIS Read)": "OXMIS", "Category": "test" } }, { "code": "L0010GB", "description": "REFERRED TO MAMMOGRAPHY CLINIC", "attributes": { "Entity type": "res22: screen_breast", "Coding System (OXMIS Read)": "OXMIS", "Category": "test" } }, { "code": "X9110", "description": "MAMMOGRAM", "attributes": { "Entity type": "res22: screen_breast", "Coding System (OXMIS Read)": "OXMIS", "Category": "test" } }, { "code": "X9111", "description": "MAMMOGRAM NORMAL", "attributes": { "Entity type": "res22: screen_breast", "Coding System (OXMIS Read)": "OXMIS", "Category": "test" } }, { "code": "X9111AB", "description": "MAMMOGRAM ABNORMAL", "attributes": { "Entity type": "res22: screen_breast", "Coding System (OXMIS Read)": "OXMIS", "Category": "test" } }, { "code": "Y060 E", "description": "BREAST SCREENING EXAMINATION", "attributes": { "Entity type": "res22: screen_breast", "Coding System (OXMIS Read)": "OXMIS", "Category": "test" } }, { "code": "Y1000HB", "description": "BREAST SCREENING", "attributes": { "Entity type": "res22: screen_breast", "Coding System (OXMIS Read)": "OXMIS", "Category": "test" } }, { "code": "Y600 EN", "description": "BREAST SCREENING EXAMINATION NORMAL", "attributes": { "Entity type": "res22: screen_breast", "Coding System (OXMIS Read)": "OXMIS", "Category": "test" } } ] } ], "status": 2, "doi": "https://doi.org/10.48533/9tty-zs64", "is_deleted": null, "publish_status": 2, "owner": "ieuan.scanlon", "template": { "id": 1, "name": "Clinical-Coded Phenotype", "description": "Phenotype definitions that are based on lists of clinical codes, or algorithms using clinical codes.", "version_id": 1 }, "versions": [ { "version_id": 776, "version_name": "Screen Breast", "version_date": "2021-10-06T16:16:58.759670Z", "is_published": true, "is_latest": true } ] } ]