RESEARCH ARTICLE Mammography Screening in a Large Health System Following the U.S. Preventive Services Task Force Recommendations and the Affordable Care Act

Background Practice recommendations for mammography screening were issued by the U.S. Preven-tive Services Task Force in 2009 and expansion of insurance coverage was provided under the Patient Protection and Affordable Care Act soon thereafter, yet the influence of these changes on screening practices in the United States is not known. Methods To determine changes in mammography screening and their associations with new practice recommendations and the Affordable Care Act, we examined patient-level data from 249,803 screening mammograms from January 1, 2008 through December 31, 2012 in a large community-based health system in the northwestern United States. Associations were determined by an intervention analysis of time-series data method. Results Among women screened, 64 % were age 50-74 years; 84 % self-identified as white race; 62 % had commercial insurance; and 70 % were seen in facilities located in metropolita