{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,11]],"date-time":"2026-02-11T14:11:33Z","timestamp":1770819093545,"version":"3.50.1"},"reference-count":30,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2014,12,23]],"date-time":"2014-12-23T00:00:00Z","timestamp":1419292800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100000869","name":"Susan G. Komen for the Cure","doi-asserted-by":"crossref","award":["KG090134"],"award-info":[{"award-number":["KG090134"]}],"id":[{"id":"10.13039\/100000869","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/100000054","name":"National Cancer Institute","doi-asserted-by":"crossref","award":["UO1-CA70013"],"award-info":[{"award-number":["UO1-CA70013"]}],"id":[{"id":"10.13039\/100000054","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J American Geriatrics Society"],"published-print":{"date-parts":[[2015,1]]},"abstract":"<jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>To prospectively examine how age and comorbidity affect screening mammography use, cancer detection, and overall survival.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>Prospective, with median follow\u2010up of 10.2\u00a0years.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>A population\u2010based cohort of Vermont women with data in the Vermont Breast Cancer Surveillance System.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Participants<\/jats:title>\n                    <jats:p>Women aged 70 and older with no history of breast cancer (N\u00a0=\u00a020,697).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Measurements<\/jats:title>\n                    <jats:p>Rates of screening, diagnostic procedure use, and breast cancer diagnosis were examined according to age and comorbidity. The effect of breast cancer on overall survival was assessed in relation to detection mode, tumor characteristics, and treatment.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Screening declined 9% per year after age 70 and 18% with each unit increase in comorbidity score, with corresponding increases in clinically detected breast cancer. Invasive cancer was associated with greater overall mortality (screen detected: hazard ratio (\n                      <jats:styled-content style=\"fixed-case\">HR<\/jats:styled-content>\n                      )\u00a0=\u00a01.22, 95% confidence interval (\n                      <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>\n                      ) \u00a0=\u00a01.07\u20131.40; clinically detected:\n                      <jats:styled-content style=\"fixed-case\">HR<\/jats:styled-content>\n                      \u00a0=\u00a01.68, 95%\n                      <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>\n                      \u00a0=\u00a01.43\u20131.96). The latter\n                      <jats:styled-content style=\"fixed-case\">HR<\/jats:styled-content>\n                      reflects a much greater absolute risk of death for women in a population with high baseline mortality. Use of breast\u2010conserving surgery as the only treatment for Stage I cancer increased markedly with age and was associated with shorter overall survival than radiation or mastectomy (relative risk\u00a0=\u00a02.23, 95%\n                      <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>\n                      \u00a0=\u00a01.42\u20133.47).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Lower screening mammography use by older women is associated with more clinically detected breast cancers, which are associated with poorer survival. Treatment received for early\u2010stage cancer influences the effect of screening on survival.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/jgs.13184","type":"journal-article","created":{"date-parts":[[2014,12,24]],"date-time":"2014-12-24T00:07:35Z","timestamp":1419379655000},"page":"1-7","source":"Crossref","is-referenced-by-count":20,"title":["A Prospective Study of the Use and Effects of Screening Mammography in Women Aged 70 and Older"],"prefix":"10.1111","volume":"63","author":[{"given":"Pamela M.","family":"Vacek","sequence":"first","affiliation":[{"name":"Medical Biostatistics Unit College of Medicine University of Vermont Burlingon Vermont"},{"name":"Department of Pathology College of Medicine University of Vermont Burlingon Vermont"},{"name":"Vermont Cancer Center University of Vermont and Fletcher Allen Health Care Burlington Vermont"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Joan M.","family":"Skelly","sequence":"additional","affiliation":[{"name":"Medical Biostatistics Unit College of Medicine University of Vermont Burlingon Vermont"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2014,12,23]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-137-5_Part_1-200209030-00012"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(02)08020-0"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1532-5415.2012.04188.x"},{"key":"e_1_2_6_5_1","unstructured":"American Cancer Society recommendations for early breast cancer detection in women without breast symptoms [on\u2010line]. 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