Martey S Dodoo PhD, Presenter: Nothing to Disclose

Richard Duszak MD, Abstract Co-Author: Nothing to Disclose

Danny Hughes PhD, Abstract Co-Author: Nothing to Disclose

Geraldine B. McGinty MD, Abstract Co-Author: Nothing to Disclose

To estimate rates and intervals between repeated screening mammography examinations for elderly Medicare beneficiaries, using recently published “repeat imaging” classification criteria.

A 5% national random sample of Medicare beneficiary physician office and outpatient hospital claims data for female elderly beneficiaries, 66 years and above was used. From that data we selected beneficiaries enrolled continuously in Medicare and alive throughout each of 2 periods five years apart: 2004–2006, and 2009–2011. These periods are essentially pre- and post- publication of the revised 2009 US Preventive Services Task Force (USPSTF) recommended changes. Administrative claims for screening mammography were identified using the appropriate CPT/HCPCS/ICD-9 codes. From the dates of service for those claims, we computed screening rates and intervals between repeated screenings. The rates and intervals were compared for the 2 periods, by age group, and by state of beneficiary residence. Denominators were defined using the Neiman Health Policy Institute classification system.

There were 1,081,981 elderly females in our 2004-2006 beneficiary group, and 866,792 in our 2009-2011 group. Average screening rates were 53.3% in 2004-2006 but dropped to 48.2% in 2009-2011. Far fewer (29.1%) of the 2004–2006 group underwent repeated screening, and even fewer (22.8%) in the 2009-2011 group underwent repeated screening. Screening rates were down for every elderly age group and in every state. Screening intervals were centered around 12, not 24 months. After the revised USPSTF guidelines fewer Medicare women are undergoing screening mammography. Women who undergo repeated screening seem to have maintained the 12-month interval between screenings (average 14.5 months in 2004-2006, and 13.9 months in 2009-2011).

Only 48% of Medicare elderly beneficiaries underwent any screening mammography in a recent 3-year window, and only 22% underwent any repeated screening. Those who underwent repeated screenings overwhelmingly did so at 1-year (not 2-year) intervals.

Screening mammography intervals have remained static despite 2009 USPSTF recommendations, but overall screening rates have declined. Increasing compliance and patient access merits attention.

Dodoo, M, Duszak, R, Hughes, D, McGinty, G, The State of Screening Mammography from 2004 to 2011: Screening Rates are Down Nationwide as USPSTF Guidelines are Ignored.  Radiological Society of North America 2013 Scientific Assembly and Annual Meeting, December 1 - December 6, 2013 ,Chicago IL. http://archive.rsna.org/2013/13044304.html