Is Medicare spending too much on mammograms?

YALE (US) — Medicare spends more than $1 billion a year on breast cancer screenings, but a new study raises questions about the benefits.

Researchers calculated Medicare expenditures for breast cancer screening and treatment in 137,274 female beneficiaries who were not diagnosed with breast cancer before 2006, and followed them for two years to observe screening, breast cancer incidence, and associated cost.


The team found substantial variation across geographic regions in Medicare spending for breast cancer screening—ranging from $40 to $110 per female beneficiary. The majority of the cost differences were due to the use of newer, more expensive screening technologies. The findings are reported in Online First in JAMA Internal Medicine.

“Although screening costs varied more than two-fold across geographic regions, there was no evidence that higher expenditures were benefiting women living in the high-cost regions,” says Cary Gross, associate professor of internal medicine at Yale University. “Specifically, there was no relation between screening expenditures and the detection of advanced cancers.”

Recent guidelines from the United States Preventive Services Task Force have concluded that there is insufficient evidence regarding the effectiveness of breast cancer screening for women age 75 years and older. The team found that more than $400 million is being spent annually on screening Medicare beneficiaries in this age group.

“We need further studies to identify which women will benefit from screening, and how to screen effectively and efficiently,” Gross says. “In some instances, breast cancer screening can save lives. But no woman wants to undergo testing if it is likely to cause more harm than good, and no health system—particularly ours—can afford to spend hundreds of millions of dollars on screening programs without evidence to support them.”

Funding from the National Cancer Institute supported the study.

Source: Yale University