Is Screening Older Women for Breast Cancer Worth It?

Breast cancer screening benefits in older women questioned

(RxWiki News) Breast cancer screening guidelines have been changing. There’s controversy about when screening should start - at 40 or 50 or not at all. But at what age should a woman stop having mammograms? Are we spending money on unnecessary screenings?

A recent study has found that Medicare spends more than $1 billion per year on breast cancer screenings. Spending patterns vary across the country. Researchers suggested that higher spending does not find more advanced breast cancers.

Additionally, women 75 years and older received mammograms, despite recommendations against screenings ladies in this age group.

"Talk to your doctor about breast cancer screenings that make sense for you."

Cary Gross, MD, associate professor of internal medicine at Yale School of Medicine and director of the Cancer Outcomes, Public Policy, and Effectiveness Research (COPPER) Center at Yale, led the study that looked at the overall costs of screening Medicare beneficiaries.

The team examined all the costs of screening and treating 137,274 women between the ages of 66 and 100 who had not been diagnosed before 2006 and 2007.

Depending on the geographic region, Medicare spent between $42-107 per beneficiary. Using newer and more expensive technology, including digital mammography and computer-aided detection, accounted for the dollar differences.

The total annual cost for screening Medicare beneficiaries was $1.08 billion.

"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," Dr. Gross said in a statement. "Specifically, there was no relation between screening expenditures and the detection of advanced cancers."

Women who received higher-cost services were more than 78 percent more likely to be diagnosed with early cancers than women in the lower-cost regions.

The United States Preventive Services Task Force now recommends that women stop having mammograms when they reach 75. That guideline apparently isn’t being followed, as the COPPER team found that $410 million was spent on this age group.

The authors noted that a two-year follow-up may be insufficient to detect advanced cancers.

Dr. Gross urged more research to specify women who will benefit from breast cancer screening, while avoiding unnecessary and potentially harmful screening in those who don’t need it.

This study was published January 7 in JAMA Internal Medicine.

This study was supported by the National Cancer Institute and the P30 Cancer Center Support Grant at the Yale Comprehensive Cancer Center. No conflicts of interest were reported.

Review Date: 
January 7, 2013