Medicare beneficiaries seem to be ignoring the United States Preventive Service Task Force (USPSTF) guidelines on screening mammography intervals, even as overall screening rates decline, according to research presented at the Radiological Society of North America Annual Meeting Thursday in Chicago.
Those guidelines recommended that routine screening of average risk women should begin at 50 and that women should get screening mammograms every two years instead of annually.
Researchers Richard Duszak, M.D. (pictured), Danny Hughes, Ph.D., Geraldine B. McGinty, M.D., and Martey Dodoo, Ph.D., who presented the study, looked at a 5 percent national random sample of Medicare beneficiary physician office and hospital claims data for female Medicare beneficiaries enrolled continuously in Medicare. From there, the researchers selected women who were alive and continuously enrolled in Medicare during two study periods--2004 to 2006, and 2009 to 2011, the latter of which represents the period immediately following the issuance of the revised USPSTF mammography screening guidelines.
There were almost 1.1 million women in the 2004 to 2006 beneficiary group, and almost 867,000 in the 2009 to 2011 group. Dodoo and his colleagues found that the average screening rates fell from 53.3 percent in the 2004 to 2006 group to 48.2 percent in the 2009 to 2011 group. Only 29 percent of the 2004 to 2006 group underwent repeated screening, while just 22 percent of the 2009 to 2011 group underwent repeated screening. The researchers also found that these rates were down for every elderly age group, and across every state.
However, despite the fact that screening rates have fallen since the USPSTF guidelines were issued, women continue to get screened annually instead of following the two-year interval recommendation. According to the researchers, women who underwent repeated screening during the more recent period did so at an average interval of 13.9 months, which is actually shorter than the average interval in the earlier period (14.5 months).
Dodoo and his colleagues concluded that while it is clear that women who undergo repeated mammograms clearly are doing so at one-year intervals (despite the USPSTF recommendations), the decline in overall screening rates should cause concern about compliance and screening access.