Revised mammography guidelines may explain breast screening decline in US
In 2009, the U.S. Preventative Services Task Force (USPSTF) revised its breast cancer screening guidelines, recommending women between 50 and 74 years old receive biennial mammograms, rather than annual routine mammograms for women between the 40 and 49 years old.
These changes may help explain the continuous decline in breast screening exams in the U.S. since 2010, according to a recent study published by the American Journal of Roentgenology.
Researchers from the Yale School of Medicine and Thomas Jefferson University Hospital in Philadelphia reviewed national Medicare Part B Physician/Supplier Procedure Summary master files from 2005 to 2015.
Led by Gilda Boroumand, MD, a radiologist at Yale New Haven Hospital, the team determined the annual utilization rate of mammograms based on procedure codes used for film-screen and digital screening mammography. The master files were also used to find the number of screening and diagnostic digital breast tomosynthesis (DBT) studies performed in 2015 (which was approved by the FDA in 2011).
The utilization rate of breast screenings abruptly decreased since 2010. The 2009 revised breast cancer screening guidelines are suspected to have been the reason for this decline, according to the researchers.
The utilization rate per 1,000 women with Medicare increased gradually every year from 311.5 examinations in 2005 to 322.9 examinations in 2009, equating to a compound annual growth rate of 0.9 percent. However, in 2010 the utilization rate decreased by 4.3 percent to 309.2 examinations. According to the researchers, in 2015, 18.9 percent of screening and 16.2 percent of diagnostic digital mammography examinations included DBT as an additional procedure.
"The rate of screening mammography utilization in 2015 was 300.9 examinations, compared with the 2009 peak of 322.9 examinations, representing a 6.8 percent decrease," the researchers wrote. "Compared with 2005, this represents a 3.4 percent decrease."
The researchers concluded that the data suggests radiology practices should not expect an increase in breast screenings unless policy changes are made to encourage women to undergo more screenings.
"Given that DBT was first introduced as a billable Medicare procedure in 2015, we believe that our finding of almost 20 percent DBT utilization in this population during that year is still promising for the future of tomosynthesis and that is suggests crossover from the experimental to the clinical realm," according to the researchers.
A recent graduate from Dominican University (IL) with a bachelor’s in journalism, Melissa joined TriMed’s Chicago team in 2017 covering all aspects of health imaging. She’s a fan of singing and playing guitar, elephants, a good cup of tea, and her golden retriever Cooper.