July 2019
Volume 60, Issue 9
Free
ARVO Annual Meeting Abstract  |   July 2019
Association between Vision Loss and Screening Mammography among Women with Medicare
Author Affiliations & Notes
  • Annie Mao Wu
    Department of Ophthalmology and Visual Sciences, W.K. Kellogg Eye Center, University of Michigan, Ann Arbor, Michigan, United States
  • Alan R Morse
    Lighthouse Guild, New York, New York, United States
  • William H Seiple
    Lighthouse Guild, New York, New York, United States
    Department of Ophthalmology, NYU School of Medicine, New York, New York, United States
  • Nidhi Talwar
    Department of Ophthalmology and Visual Sciences, W.K. Kellogg Eye Center, University of Michigan, Ann Arbor, Michigan, United States
  • Sean Hansen
    Department of Ophthalmology and Visual Sciences, W.K. Kellogg Eye Center, University of Michigan, Ann Arbor, Michigan, United States
  • Paul P Lee
    Department of Ophthalmology and Visual Sciences, W.K. Kellogg Eye Center, University of Michigan, Ann Arbor, Michigan, United States
    Center for Eye Policy and Innovation, University of Michigan, Ann Arbor, Michigan, United States
  • Joshua D Stein
    Department of Ophthalmology and Visual Sciences, W.K. Kellogg Eye Center, University of Michigan, Ann Arbor, Michigan, United States
    Center for Eye Policy and Innovation, University of Michigan, Ann Arbor, Michigan, United States
  • Footnotes
    Commercial Relationships   Annie Wu, None; Alan Morse, Novartis (C), Spark Therapeutics (C); William Seiple, None; Nidhi Talwar, None; Sean Hansen, None; Paul Lee, CDC (C); Joshua Stein, None
  • Footnotes
    Support  Lighthouse Guild; RPB; R01 EY026641
Investigative Ophthalmology & Visual Science July 2019, Vol.60, 3637. doi:
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    • Get Citation

      Annie Mao Wu, Alan R Morse, William H Seiple, Nidhi Talwar, Sean Hansen, Paul P Lee, Joshua D Stein; Association between Vision Loss and Screening Mammography among Women with Medicare. Invest. Ophthalmol. Vis. Sci. 2019;60(9):3637.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Purpose : To assess whether visual impairment affects receiving screening mammograms to check for breast cancer in accordance with USPSTF recommendations.

Methods : Females aged 65-72 years with severe, partial, and no vision loss were identified from a 20% sample of enrollees in Medicare from 2008-2015. Partial vision loss was defined as visual impairment involving 1 eye, and severe as visual impairment involving 2 eyes, using qualifying ICD-9 codes. Patients were matched 1:1:1 across groups based on age, calendar year at start of follow up, race, urban-rural category of residence, and overall health. Women with pre-existing breast cancer were excluded. We studied the receipt of screening mammography within a 3-year look-back and 2-year follow-up period among the 3 groups. Multivariable conditional logistic regression modeling determined the odds of receiving screening mammography among visually impaired women compared to those without vision loss.

Results : A total of 1,044 patients were identified and matched (348 patients in each of the 3 groups). The mean number of mammograms received per patient during the 5-year period was 2.3 (SD 2.1), 2.5 (SD 2.0), and 3.1 (SD 2.0) for the severe, partial, and no vision loss groups, respectively (p<0.0001). The proportion of women receiving ≥ 1 mammogram within the 2-year follow-up period was 56%, 57%, and 69% for the severe, partial, and no vision loss groups, respectively (p=0.0005). After adjusting for prior mammograms during the look-back period and receipt of colonoscopy (another preventative screening test) during the study period, the group of patients with severe vision loss had 42% decreased odds (OR=0.58; 95% CI 0.37-0.90), and the group with partial vision loss had 44% decreased odds (OR=0.56; 95% CI 0.36-0.87) of receiving mammography during the follow-up period compared with the group of patients without vision loss.

Conclusions : Within this Medicare cohort, women with visual impairment were significantly less likely to receive screening mammography to check for breast cancer than their non-visually-impaired peers. Health care professionals should look for ways to help ensure that patients with visual or other disabilities receive mammograms and other preventative screenings as recommended by the USPSTF.

This abstract was presented at the 2019 ARVO Annual Meeting, held in Vancouver, Canada, April 28 - May 2, 2019.

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