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Breast Cancer Screening, Incidence, and Mortality Across US Counties

Overview of attention for article published in JAMA Internal Medicine, September 2015
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About this Attention Score

  • In the top 5% of all research outputs scored by Altmetric
  • High Attention Score compared to outputs of the same age (99th percentile)
  • High Attention Score compared to outputs of the same age and source (97th percentile)

Mentioned by

news
32 news outlets
blogs
14 blogs
policy
1 policy source
twitter
771 tweeters
facebook
48 Facebook pages
wikipedia
1 Wikipedia page
googleplus
9 Google+ users
reddit
2 Redditors

Citations

dimensions_citation
116 Dimensions

Readers on

mendeley
184 Mendeley
citeulike
6 CiteULike
Title
Breast Cancer Screening, Incidence, and Mortality Across US Counties
Published in
JAMA Internal Medicine, September 2015
DOI 10.1001/jamainternmed.2015.3043
Pubmed ID
Authors

Charles Harding, Francesco Pompei, Dmitriy Burmistrov, H. Gilbert Welch, Rediet Abebe, Richard Wilson

Abstract

Screening mammography rates vary considerably by location in the United States, providing a natural opportunity to investigate the associations of screening with breast cancer incidence and mortality, which are subjects of debate. To examine the associations between rates of modern screening mammography and the incidence of breast cancer, mortality from breast cancer, and tumor size. An ecological study of 16 million women 40 years or older who resided in 547 counties reporting to the Surveillance, Epidemiology, and End Results cancer registries during the year 2000. Of these women, 53 207 were diagnosed with breast cancer that year and followed up for the next 10 years. The study covered the period January 1, 2000, to December 31, 2010, and the analysis was performed between April 2013 and March 2015. Extent of screening in each county, assessed as the percentage of included women who received a screening mammogram in the prior 2 years. Breast cancer incidence in 2000 and incidence-based breast cancer mortality during the 10-year follow-up. Incidence and mortality were calculated for each county and age adjusted to the US population. Across US counties, there was a positive correlation between the extent of screening and breast cancer incidence (weighted r = 0.54; P < .001) but not with breast cancer mortality (weighted r = 0.00; P = .98). An absolute increase of 10 percentage points in the extent of screening was accompanied by 16% more breast cancer diagnoses (relative rate [RR], 1.16; 95% CI, 1.13-1.19) but no significant change in breast cancer deaths (RR, 1.01; 95% CI, 0.96-1.06). In an analysis stratified by tumor size, we found that more screening was strongly associated with an increased incidence of small breast cancers (≤2 cm) but not with a decreased incidence of larger breast cancers (>2 cm). An increase of 10 percentage points in screening was associated with a 25% increase in the incidence of small breast cancers (RR, 1.25; 95% CI, 1.18-1.32) and a 7% increase in the incidence of larger breast cancers (RR, 1.07; 95% CI, 1.02-1.12). When analyzed at the county level, the clearest result of mammography screening is the diagnosis of additional small cancers. Furthermore, there is no concomitant decline in the detection of larger cancers, which might explain the absence of any significant difference in the overall rate of death from the disease. Together, these findings suggest widespread overdiagnosis.

Twitter Demographics

The data shown below were collected from the profiles of 771 tweeters who shared this research output. Click here to find out more about how the information was compiled.

Mendeley readers

The data shown below were compiled from readership statistics for 184 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
United States 2 1%
France 1 <1%
Chile 1 <1%
United Kingdom 1 <1%
Germany 1 <1%
Unknown 178 97%

Demographic breakdown

Readers by professional status Count As %
Other 27 15%
Student > Ph. D. Student 27 15%
Student > Master 20 11%
Researcher 19 10%
Student > Bachelor 17 9%
Other 53 29%
Unknown 21 11%
Readers by discipline Count As %
Medicine and Dentistry 84 46%
Agricultural and Biological Sciences 14 8%
Nursing and Health Professions 9 5%
Engineering 8 4%
Social Sciences 7 4%
Other 32 17%
Unknown 30 16%

Attention Score in Context

This research output has an Altmetric Attention Score of 871. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 12 May 2020.
All research outputs
#7,906
of 15,570,875 outputs
Outputs from JAMA Internal Medicine
#109
of 4,058 outputs
Outputs of similar age
#103
of 233,326 outputs
Outputs of similar age from JAMA Internal Medicine
#4
of 147 outputs
Altmetric has tracked 15,570,875 research outputs across all sources so far. Compared to these this one has done particularly well and is in the 99th percentile: it's in the top 5% of all research outputs ever tracked by Altmetric.
So far Altmetric has tracked 4,058 research outputs from this source. They typically receive a lot more attention than average, with a mean Attention Score of 135.8. This one has done particularly well, scoring higher than 97% of its peers.
Older research outputs will score higher simply because they've had more time to accumulate mentions. To account for age we can compare this Altmetric Attention Score to the 233,326 tracked outputs that were published within six weeks on either side of this one in any source. This one has done particularly well, scoring higher than 99% of its contemporaries.
We're also able to compare this research output to 147 others from the same source and published within six weeks on either side of this one. This one has done particularly well, scoring higher than 97% of its contemporaries.