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Research Letter to Editor|Articles in Press, 101407

Alzheimer's disease and related dementias is a risk factor for lower utilization of breast cancer screening and unstaged cancer diagnosis: Observational study from SEER-Medicare 2004–2016 data

Published:November 26, 2022DOI:https://doi.org/10.1016/j.jgo.2022.11.006
      Patients with Alzheimer's Disease and Related Dementias (ADRD) could face numerous challenges in obtaining screening mammograms and being accurately staged for breast cancer [
      • McWilliams L.
      • Farrell C.
      • Grande G.
      • Keady J.
      • Swarbrick C.
      • Yorke J.
      A systematic review of the prevalence of comorbid cancer and dementia and its implications for cancer-related care.
      ]. For example, the cognitive challenges for patients with ADRD may make it hard to perform screening tests, and their families may forgo surgeries which can provide accurate staging information [
      • McWilliams L.
      • Farrell C.
      • Grande G.
      • Keady J.
      • Swarbrick C.
      • Yorke J.
      A systematic review of the prevalence of comorbid cancer and dementia and its implications for cancer-related care.
      ]. Since the patient population with breast cancer and ADRD is expected to increase, studies are much needed on this vulnerable population. In the literature, little is known about the difference between patients with breast cancer with ADRD and those without ADRD, in terms of the percentage receiving screening mammograms and the distribution of cancer stages at diagnosis. Raji and colleagues previously emphasized a much higher overall mortality among patients with breast cancer and pre-existing dementia [
      • Raji M.A.
      • Kuo Y.F.
      • Freeman J.L.
      • Goodwin J.S.
      Effect of a dementia diagnosis on survival of older patients after a diagnosis of breast, colon, or prostate cancer: implications for cancer care.
      ]. However, their study did not specifically compare the stage at diagnosis and the utilization patterns of screening mammograms, and their data were at least 20 years old [
      • Raji M.A.
      • Kuo Y.F.
      • Freeman J.L.
      • Goodwin J.S.
      Effect of a dementia diagnosis on survival of older patients after a diagnosis of breast, colon, or prostate cancer: implications for cancer care.
      ].

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