Breast cancer screening (BCS) with mammography is a crucial method for improving cancer survival. In this study, we examined the association of Alzheimer's disease (AD) and AD-related dementias (ADRD) diagnosis and race-ethnicity with mammography use in BCS-eligible women. In the real-world data from the OneFlorida+ Clinical Research Network, we extracted a cohort of 21,715 BCS-eligible women with ADRD and a matching comparison cohort of 65,145 BCS-eligible women without ADRD. In multivariable regression analysis, BCS-eligible women with ADRD were more likely to undergo a mammography than the BCS-eligible women without ADRD (odds ratio [OR] = 1.19, 95% confidence interval [CI] = 1.13-1.26). Stratified by race-ethnicity, BCS-eligible Hispanic women with ADRD were more likely to undergo a mammography (OR = 1.56, 95% CI = 1.39-1.75), whereas BCS-eligible non-Hispanic black (OR = 0.72, 95% CI = 0.62-0.83) and non-Hispanic other (OR = 0.65, 95% CI = 0.45-0.93) women with ADRD were less likely to undergo a mammography. This study was the first to report the impact of ADRD diagnosis and race-ethnicity on mammography use in BCS-eligible women using real-world data. Our results suggest ADRD patients might be undergoing BCS without detailed guidelines to maximize benefits and avoid harms.
Keywords: cognitive impairment; electronic health record; mammography; screening; social determinant of health.