Association of Breast Cancer Screening Behaviors With Stage at Breast Cancer Diagnosis and Potential for Additive Multi-Cancer Detection via Liquid Biopsy Screening: A Claims-Based Study

• Published in: Frontiers in oncology 2021-06, Vol.11, p.688455-688455
• Main Authors: Hathaway, Christine, Paetsch, Peter, Li, Yali, Wu, Jincao, Asgarian, Sam, Parker, Alex, Welsh, Alley, Deverka, Patricia, Cohain, Ariella
• Format: Article
• Language: English
• Subjects: breast cancer; cancer screening; earlier detection; liquid biopsy; mammography; Oncology; preventive care
• ISSN: 2234-943X; 2234-943X
• DOI: 10.3389/fonc.2021.688455

To evaluate mammography uptake and subsequent breast cancer diagnoses, as well as the prospect of additive cancer detection a liquid biopsy multi-cancer early detection (MCED) screening test during a routine preventive care exam (PCE). Patients with incident breast cancer were identified from five years of longitudinal Blue Health Intelligence (BHI ) claims data (2014-19) and their screening mammogram and PCE utilization were characterized. Ordinal logistic regression analyses were performed to identify the association of a biennial screening mammogram with stage at diagnosis. Additional screening opportunities for breast cancer during a PCE within two years before diagnosis were identified, and the method extrapolated to all cancers, including those without recommended screening modalities. Claims for biennial screening mammograms and the time from screening to diagnosis were found to be predictors of breast cancer stage at diagnosis. When compared to women who received a screening mammogram proximal to their breast cancer diagnosis (0-4 months), women who were adherent to guidelines but had a longer time window from their screening mammogram to diagnosis (4-24 months) had a 87% increased odds of a later-stage (stages III or IV) breast cancer diagnosis (p-value