Advertisement

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.
      ].

      Keywords

      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'

      Subscribe:

      Subscribe to Journal of Geriatric Oncology
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect

      References

        • 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.
        Aging Ment Health. 2018; 22: 1254-1271
        • 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.
        Arch Intern Med. 2008; 168: 2033-2040
        • National Cancer Institute
        SEER-Medicare Linked Database.
        • Chronic Condition Data Warehouse
        Condition categories: Alzheimer’s disease and related disorders or senile dementia.
        (Accessed Nov 24, 2022)
      1. National Cancer Institute Site Recode ICD-O-3/WHO 2008 Definition. (Accessed August 21, 2020) https://seer.cancer.gov/siterecode/icdo3_dwhoheme/index.html.

        • Killelea B.K.
        • Long J.B.
        • Chagpar A.B.
        • et al.
        Evolution of breast cancer screening in the Medicare population: clinical and economic implications.
        J Natl Cancer Inst. 2014; 106
      2. Centers for Medicare and Medicaid Services Frequently Asked Questions for Mammography Services. https://www.cms.gov/Medicare/Medicare-Fee-for-Service-Payment/PhysicianFeeSched/Downloads/FAQ-Mammography-Services-Coding-Direct-Digital-Imaging.pdf.

      3. ICD10Data.com Convert ICD-9-CM Codes to ICD-10-CM/PCS, or Convert ICD-10-CM/PCS Codes to ICD-9-CM. (Accessed September 2nd, 2021) https://www.icd10data.com/Convert.

        • Poleszczuk J.
        • Luddy K.
        • Chen L.
        • et al.
        Neoadjuvant radiotherapy of early-stage breast cancer and long-term disease-free survival.
        Breast Cancer Res. 2017; 19: 75
        • Henry K.A.
        • Sherman R.L.
        • McDonald K.
        • et al.
        Associations of census-tract poverty with subsite-specific colorectal cancer incidence rates and stage of disease at diagnosis in the United States.
        J Cancer Epidemiol. 2014; 2014823484
        • SAS [computer program]
        Version 9.4.
        SAS Institute Inc, Cary, NC2014
        • Chalmers J.
        • Pullan M.
        • Fabri B.
        • et al.
        Validation of EuroSCORE II in a modern cohort of patients undergoing cardiac surgery.
        Eur J Cardiothorac Surg. 2013; 43: 688-694
        • Walter L.C.
        • Covinsky K.E.
        Cancer screening in elderly patients: a framework for individualized decision making.
        JAMA. 2001; 285: 2750-2756
        • Raik B.L.
        • Miller F.G.
        • Fins J.J.
        Screening and cognitive impairment: ethics of forgoing mammography in older women.
        J Am Geriatr Soc. 2004; 52: 440-444