health

Mammogram numbers steady despite advice to cut frequency

A 2009 task force recommendation for screening every two years for most women doesn't seem to have affected mammography rates nationwide, a new study shows.

By — Posted May 6, 2013

Print  |   Email  |   Respond  |   Reprints  |   Like Facebook  |   Share Twitter  |   Tweet Linkedin

Despite controversial recommendations by a government-backed task force in 2009 to reduce the rate of mammograms, the numbers of women getting them regularly have not changed significantly, according to a study in the April 19 issue of Cancer.

The U.S. Preventive Services Task Force, appointed to advise doctors, insurance companies and policymakers, recommended screening every two years for women 50 to 74 years old. For women younger than 50, the task force advised physicians and patients to decide together case by case whether to get screened. The guidelines were a departure from the panel's 2002 recommendation that women 40 and older should have the screening every one to two years.

However, years after the 2009 recommendation, numbers have not dropped, according to researchers at Brigham and Women's Hospital in Boston. They studied responses from more than 28,000 women who answered National Health Interview Survey questions in 2005, 2008 and 2011 about mammogram frequency. They found that among women 40 to 49, rates of women who had a mammogram in the past 12 months rose slightly, from 46.1% in 2008 to 47.5% in 2011. For women ages 50 to 74, the rates also inched up, from 57.2% in 2008 to 59.1% in 2011.

Although the study didn't examine the reasons for getting regular mammograms, lead author Lydia Pace, MD, MPH, global women's health fellow at Brigham and Women's, speculated that several factors may account for the virtually unchanged numbers. Likely reasons, she said, are confusion by physicians and patients over the task force's recommendations; decisions by some organizations, including the American Cancer Society, to stick with the previous recommendations; and insurance companies continuing coverage of annual mammograms. The American Medical Association adopted policy at its 2012 Annual Meeting stating that women older than 40 must be able to receive the procedure if they request it and insurance should cover the screening.

“It may be that providers don't have the time or don't have the tools or don't feel prepared to go through an in-depth risk/benefit discussion with patients,” Dr. Pace said.

Timing not likely an issue

Dr. Pace acknowledged that it's possible that the study came too soon after the recommendations to reflect change, but she said a few factors make that unlikely. One is that rates for prostate-specific antigen screening dropped significantly within a year after USPSTF recommended against the test for older men. The other is that the news of the task force's recommendations was widely known, so it's unlikely patients and doctors were slow to hear about them.

Michael LeFevre, MD, MSPH, co-vice chair of the task force, said it was “not a huge surprise that mammography did not decline.”

He said he suspects that physicians continue to recommend, rather than discuss, mammography, and added that given the controversy that followed the recommendations and the pushback from some physician organizations, some may just consider it easier to recommend the procedure routinely.

Dr. LeFevre acknowledges that the original language in the recommendations was confusing and led to many misunderstandings, a fault the panel hopes to correct in the next review with better communication and transparency. “We owe it to the public to do a good job of communicating what the science says,” he said.

The task force revisits recommendations roughly every five years, Dr. LeFevre said, adding that mammography is on track to be reviewed again in 2014.

Back to top


External links

“Trends in mammography screening rates after publication of the 2009 US Preventive Services Task Force recommendations,” Cancer, published online April 19 (link)

Back to top


ADVERTISEMENT

ADVERTISE HERE


Featured
Read story

Confronting bias against obese patients

Medical educators are starting to raise awareness about how weight-related stigma can impair patient-physician communication and the treatment of obesity. Read story


Read story

Goodbye

American Medical News is ceasing publication after 55 years of serving physicians by keeping them informed of their rapidly changing profession. Read story


Read story

Policing medical practice employees after work

Doctors can try to regulate staff actions outside the office, but they must watch what they try to stamp out and how they do it. Read story


Read story

Diabetes prevention: Set on a course for lifestyle change

The YMCA's evidence-based program is helping prediabetic patients eat right, get active and lose weight. Read story


Read story

Medicaid's muddled preventive care picture

The health system reform law promises no-cost coverage of a lengthy list of screenings and other prevention services, but some beneficiaries still might miss out. Read story


Read story

How to get tax breaks for your medical practice

Federal, state and local governments offer doctors incentives because practices are recognized as economic engines. But physicians must know how and where to find them. Read story


Read story

Advance pay ACOs: A down payment on Medicare's future

Accountable care organizations that pay doctors up-front bring practice improvements, but it's unclear yet if program actuaries will see a return on investment. Read story


Read story

Physician liability: Your team, your legal risk

When health care team members drop the ball, it's often doctors who end up in court. How can physicians improve such care and avoid risks? Read story

  • Stay informed
  • Twitter
  • Facebook
  • RSS
  • LinkedIn