The Baltimore VA Medical Center screened more women with mammography after changes to accommodate the growing number of female veterans, but the changes led to increased times to treatment and more use of non-Veterans Affairs facilities for follow-up of the mammography results, according to a report published Online First by JAMA Surgery, a JAMA Network publication.
Women represent the fastest growing demographic in the U.S. veteran population, which makes breast cancer an increasingly significant public health issue for the Veterans Health Administration (VHA), according to the study background.
Charlotte L. Kvasnovsky, M.D., M.P.H., of the Baltimore Veterans Affairs Medical Center, and colleagues examined all breast cancer cases treated at the facility from January 2001 through May 2012. In 2008, programmatic changes were implemented at the facility to expand screening mammography, develop on-site breast care resources and better coordinate care with non-VA facilities.
From 2000 to 2013, 7,355 mammograms were performed and 76 patients with breast cancer received treatment, with most of those mammograms (n=6,720) being performed after 2008. A median (midpoint) of 1,453 mammograms were performed and six patients received cancer care treatment annually after 2008, according to the study results. The study notes that time from diagnosis to the start of treatment increased from 33 days to 51 days between 2008 and 2012, which researchers suspect may be due in part to increased clinical volume.
“In summary, we have shown that our hospital successfully expanded mammography. Intensified screening has increased clinical volumes and the need to use non-VA resources, and screening has been associated with an increase in time to definitive treatment. Although this was a single-center, retrospective study, it is probable that our findings are applicable to other VA hospitals,” the authors conclude.
(JAMA Surgery. Published online September 18, 2013. doi:10.1001/jamasurg.2013.3738.