March 23 (UPI) – Private health insurance spends more than $ 2 billion a year on screening for women aged 40 for breast cancer, although a new study shows that less than half of those eligible for it have a mammogram.
In the results published on Monday JAMA Internal Medicineresearchers noted that just over 41 percent of women between the ages of 40 and 49 who have private insurance had a mammogram in 2017. According to researchers, the average cost per person among these women was $ 353.
“Breast cancer screening is expensive,” said study co-author Natalya Kunst, a fellow at the Yale School of Medicine and Public Health and a Ph.D. in medical decision-making at the University of Oslo in Norway.
“These significant costs are incurred despite the fact that the health outcomes associated with screening for breast cancer in this population remain uncertain and there is a mismatch between the recommendations of the professional society for screening women” in this age group, she added.
Indeed, the lack of consensus on the value of routine mammography for women aged 40 years has led to considerable confusion.
Currently, the US Preventive Services Task Force recommends that women start screening for breast cancer at the age of 50, and the American Cancer Society recommends that women do their first mammogram at the age of 45.
Most private insurance companies in the United States reimburse patients at the age of 40 for a mammogram, despite concerns about the lack of accuracy and exposure to the low radiation dose associated with the procedure.
For their study, Kunst and her colleagues examined more than 2.2 million women from the Blue Cross Blue Shield Axis, a large database of commercial applications targeting women aged 40 to 49 who were eligible for a mammogram in 2017 year.
Of the women included in the analysis, a little more than 930,000 people were examined in 2017, of which 543,380 people, or 24.1 percent, underwent a two-dimensional mammogram. Of this latter group, 387,146 people, or 17.2%, underwent breast digital tomosynthesis or DBT.
Among women who had a mammography, 137,764, or 15%, were withdrawn for diagnostic evaluation, and 20,229, or just over 2%, were referred for other diagnostic tests.
The authors found that the main contribution to the total cost of screening was mammography itself – this amounted to 249 US dollars out of a total of 353 US dollars per person – with subsequent recall – 56 US dollars and other diagnostic tests – 45 US dollars.
In general, after extrapolating these costs to the US population with private insurance, the nationwide screening costs for women aged 40 were $ 2.13 billion. USA per year, most of which was taken into account in the initial mammography.
“Our results show the importance of determining whether the benefits of screening women 40 years old outweigh the potential harm,” said Kunst. “We hope that a better understanding of the actual use and cost of breast cancer screening in this population will allow health policy makers to make more accurate decisions about breast cancer screening for women aged 40 years.”
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