Breast cancer detection hasn't increased in line with costs

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Although the Medicare costs for mammography have increased by nearly 50% over an observed 7-year period, breast cancer detection rates have shown no measurable increase, according to a recent study.

Researchers from Yale University, led by Cary Gross, MD, reviewed patient data from the National Cancer Institute's Surveillance, Epidemiology and End Results program. Approximately 133 thousand patients who had had a mammography screening between 2008 and 2009, and approximately 137 thousand patients who had a mammography between 2001 and 2002 were part of the data analysis. Median age for each group was 77 years and 76 years, respectively.

During the examined period, biopsy rate decreased slightly, and the rate of both digital image acquisition for screening mammography and incorporation of CAD into breast imaging increased. Digital image acquisition rose from 2% in the first period (2001 through 2002) to 29.8% in the second (2008 through 2009) period, and CAD use rose from 3.2% in the first period to 29.8% in the second period. per-capita costs for screening mammography increased by 43% over the study period, and plain-film mammography decreased in cost but the savings was offset by a 15-fold increase in digital mammography cost.

Despite these increases in testing and cost, breast cancer detection rates over the study period did not increase, and no significant changes in stage distribution or tumor size were observed.

Breast cancer detection hasn't increased in line with costs
Breast cancer detection hasn't increased in line with costs

Medicare's mammography costs increased by almost 50% over a 7-year period while the breast cancer detection rate and stage at diagnosis did not change, a 270,000-patient study showed.

Annual Medicare spending rose from $666 million during 2001 to 2002, to $962 million in 2008 to 2009, according to Cary P. Gross, MD, of Yale University, and colleagues. The number of women screened and detection rates for early-stage disease were similar during the two time periods.

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