Aims/hypothesis:
Studies 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.
Materials and methods:
Using 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.
Results:
Compared 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.
Conclusions/interpretation:
In 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.
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.
Code | Description | Entity type | Coding System (OXMIS Read) | Category |
---|---|---|---|---|
1A81.00 | No breast lump | res22: screen_breast | Read | test |
1A82.00 | Breast lump present | res22: screen_breast | Read | test |
1A84.00 | Breast lump detected by mammogram | res22: screen_breast | Read | test |
537..00 | Soft tissue X-ray breast | res22: screen_breast | Read | test |
537..11 | Mammography - X-ray | res22: screen_breast | Read | test |
5371.00 | Mammography requested | res22: screen_breast | Read | test |
5372.00 | Mammography normal | res22: screen_breast | Read | test |
5373.00 | Mammography abnormal | res22: screen_breast | Read | test |
5374.00 | Mammography offered | res22: screen_breast | Read | test |
5376.00 | Mammography attended | res22: screen_breast | Read | test |
537Z.00 | Soft tissue X-ray breast NOS | res22: screen_breast | Read | test |
54L3.00 | Mammary gland contrast radiog. | res22: screen_breast | Read | test |
54L3.11 | Breast contrast radiog | res22: screen_breast | Read | test |
54L3.12 | Mammary contrast radiog | res22: screen_breast | Read | test |
56B1.00 | Specific mammary gland imaging | res22: screen_breast | Read | test |
585C.00 | US scan of breast | res22: screen_breast | Read | test |
5861.00 | Thermography - breast | res22: screen_breast | Read | test |
5861.11 | Mammogram-thermographic | res22: screen_breast | Read | test |
6862.00 | Breast neoplasm screen | res22: screen_breast | Read | test |
6862.11 | Mammography - screening | res22: screen_breast | Read | test |
6862000 | Breast neoplasm screen normal | res22: screen_breast | Read | test |
6862100 | Breast neoplasm screen abnorm | res22: screen_breast | Read | test |
6862Z00 | Breast neoplasm screen NOS | res22: screen_breast | Read | test |
6865.00 | Breast neoplasm screen normal | res22: screen_breast | Read | test |
7P0F.00 | Diagnostic imaging of breast | res22: screen_breast | Read | test |
7P0F000 | Scintimammography | res22: screen_breast | Read | test |
7P0F100 | Thermography of breast | res22: screen_breast | Read | test |
7P0F200 | Mammography | res22: screen_breast | Read | test |
7P0Fy00 | Other specified diagnostic imaging of breast | res22: screen_breast | Read | test |
7P0Fz00 | Diagnostic imaging of breast NOS | res22: screen_breast | Read | test |
8HT8.00 | Referral to mammography clinic | res22: screen_breast | Read | test |
8HTI.00 | Referral to breast clinic | res22: screen_breast | Read | test |
9N0A.00 | Seen in breast clinic | res22: screen_breast | Read | test |
9N1y900 | Seen in breast clinic | res22: screen_breast | Read | test |
9Np2.00 | Seen in fast track suspected breast cancer clinic | res22: screen_breast | Read | test |
9OH9.00 | Breast screen abnorm.-told pat | res22: screen_breast | Read | test |
9OHZ.00 | Breast screening administr.NOS | res22: screen_breast | Read | test |
9Oq8.00 | Attended breast screening clinic | res22: screen_breast | Read | test |
R138.00 | [D]Breast imaging abnormal | res22: screen_breast | Read | test |
R138000 | [D]Mammogram abnormal | res22: screen_breast | Read | test |
R138z00 | [D]Breast imaging abnormal NOS | res22: screen_breast | Read | test |
ZV76100 | [V]Screening for malignant neoplasm of breast | res22: screen_breast | Read | test |
Code | Description | Entity type | Coding System (OXMIS Read) | Category |
---|---|---|---|---|
L0010CB | SEEN IN MAMMOGRAPHY CLINIC | res22: screen_breast | OXMIS | test |
L0010GB | REFERRED TO MAMMOGRAPHY CLINIC | res22: screen_breast | OXMIS | test |
X9110 | MAMMOGRAM | res22: screen_breast | OXMIS | test |
X9111 | MAMMOGRAM NORMAL | res22: screen_breast | OXMIS | test |
X9111AB | MAMMOGRAM ABNORMAL | res22: screen_breast | OXMIS | test |
Y060 E | BREAST SCREENING EXAMINATION | res22: screen_breast | OXMIS | test |
Y1000HB | BREAST SCREENING | res22: screen_breast | OXMIS | test |
Y600 EN | BREAST SCREENING EXAMINATION NORMAL | res22: screen_breast | OXMIS | test |
To Export Phenotype Details:
Format | API |
---|---|
XML | site_root/api/v1/public/phenotypes/PH388/version/776/detail/?format=xml |
JSON | site_root/api/v1/public/phenotypes/PH388/version/776/detail/?format=json |
R Package |
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To Export Phenotype Code List:
Format | API |
---|---|
XML | site_root/api/v1/public/phenotypes/PH388/version/776/export/codes/?format=xml |
JSON | site_root/api/v1/public/phenotypes/PH388/version/776/export/codes/?format=json |
CSV | site_root/phenotypes/PH388/version/776/export/codes/ |
R Package |
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Version ID |
Name | Owner | Publish date | |
---|---|---|---|---|
776 | Screen Breast | ieuan.scanlon | 2021-10-06 | currently shown |
Export - export all codes into a csv file/JSON/XML for the current phenotype version.
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