USPSTF mammo guidelines can save billions of dollars

A study out of the University of California, San Francisco, says that the United States Preventive Services Task Force (USPSTF) mammography screening guidelines not only are designed to maximize patient benefit and minimize harm, but also provide a more effective use of healthcare dollars.

According to the study, published in the Annals of Internal Medicine, approximately 70 percent of the women in the U.S. were screened for breast cancer in 2010--some annually or biannually, and some on a more irregular basis--at a cost of $7.8 billion. The researchers estimated that screening in accordance with the USPSTF guidelines would result in a screening rate of 85 percent and would cost $3.5 billion--a savings of $4.3 billion a year.

"The USPSTF guidelines are based on the best scientific evidence to date," Laura Esserman, director of the Carol Franc Buck Breast Care Center at the UCSF Helen Diller Family Comprehensive Cancer Care Center, and a co-author of the study, said in an announcement. "What we need now is a better way to assess breast cancer risk and implement a more risk-based approach to screening. We have demonstrated that the resources for doing this are already in the system. We should redirect them to learning, enabling change and improving outcomes."

The authors compared the current rate of screening with three simulated models. One model was based on the USPSTF guidelines. A second provided for 85 percent of women between the ages of 40 and 84 getting screened in accordance with American Cancer Society guidelines, at an estimated cost of $10.1 billion annually. The third model involved biennial screening of women ages 50 to 70--in accordance with guidelines used in many European countries--at an estimated annual cost of $2.6 billion.

"Over the last decade, in study after study, it has become very clear that--apart from limited, specific high-risk groups--biennial screening is as effective as annual screening mammography," Esserman said. "At the same time, annual screening is associated with a greater likelihood of false positive results, which have an adverse impact on women's well-being and quality of life. From the viewpoint of women's health, the USPSTF screening recommendations make sense."

To learn more:
- read the study in the Annals of Internal Medicine
- see the announcement

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