David C. Levin MD, Presenter: Consultant, HealthHelp Board of Directors, Outpatient Imaging Affiliates, LLC

Vijay Madan Rao MD, Abstract Co-Author: Nothing to Disclose

Laurence Parker PhD, Abstract Co-Author: Nothing to Disclose

Andrea J. Frangos MPH, Abstract Co-Author: Nothing to Disclose

Richard Earnest Sharpe MD, MBA, Abstract Co-Author: Nothing to Disclose

In November 2009, the U.S. Preventive Services Task Force (USPSTF) issued new breast cancer screening guidelines. For women in the Medicare age bracket, this document recommended changing the screening interval from 1 to 2 years and ceasing screening at age 74. The guidelines stirred considerable controversy but it was unclear how much they would influence women’s choices about screening. Our purpose was to determine how much these recommendations impacted the use of screening mammography in the Medicare population.

The Medicare Part B Physician/Supplier Procedure Summary Master Files for 2005-2010 were searched (2010 was the first full year after the USPSTF document came out). The codes for screening mammography (both film and digital) were selected. The database provides volumes for each code each year, and from these, we calculated screening mammography rates per 1000 female Medicare beneficiaries per year. The compound annual growth rate (CAGR) was calculated for 2005 to 2009 and compared with the change from 2009 to 2010.

The screening mammography rate per 1000 Medicare female beneficiaries was 311.6 in 2005, 312.4 in 2006, 316.2 in 2007, 320.1 in 2008, and 322.9 in 2009. This represented a CAGR of 0.9% from 2005 to 2009. But in 2010 the rate dropped to 309.1, representing a decline in that single year of 4.3%.

Prior to the USPSTF recommendation, the screening mammography rate in Medicare female beneficiaries had been growing in small increments each year, with an average annual increase of just under 1%. However, after the recommendation came out in late 2009, a substantial decline (4.3%) occurred in 2010. The USPSTF document appears to have had a noticeable impact on the willingness of women to undergo breast cancer screening. This has become a very controversial issue and it will be important to follow these trends in upcoming years.

not applicable

Levin, D, Rao, V, Parker, L, Frangos, A, Sharpe, R, The Effect of the U.S. Preventive Services Task Force Recommendation on Use of Screening Mammography.  Radiological Society of North America 2012 Scientific Assembly and Annual Meeting, November 25 - November 30, 2012 ,Chicago IL. http://archive.rsna.org/2012/12022886.html