Women on Medicare with poor chances of living 4 more years often forego screening mammograms
Although experts recommend women receive regular screening mammograms to catch breast cancer early, guidelines also recommend that an older woman's life expectancy be factored in before she receives a mammogram. A new study confirms that Medicare patients and their providers do indeed consider the woman's mortality risk when making decisions about screening mammography.
Using Medicare Current Beneficiary Survey data from 2002, researchers examined mammography rates of 4,836 women age 65 and older. Fifty-two percent of the women received mammograms, and their average age was 74. Women whose life expectancies were good had higher rates of mammograms than women whose life expectancies were not as promising. For example, 62.7 percent of women whose health profiles indicated they had a low risk of dying had mammograms compared with just 24 percent of women whose life expectancies were estimated to be 4 years or fewer.
The authors believe more research is needed to determine whether the 62.7 percent rate for healthy women indicates an underuse of screening mammography and if the 24 percent screening rate in unhealthy women is an overuse of the technology. This study also indicates that providers are able to spot predictors of life expectancy in their older patients and that patients are willing to accept their providers' recommendations when it comes to the benefit of screening for breast cancer. This study was funded in part by the Agency for Healthcare Research and Quality (HS13851).
See "Screening mammography use in Medicare beneficiaries reflects 4-year mortality risk," by Deepika L. Koya, M.D., M.S.C.R., John G. Chen, M.D., Ph.D., Tom G. Smith, Ph.D., and William P. Moran, M.D., M.S., in the April 2011 The American Journal of Medicine 124(4); pp. 369.e1-369.e8.
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