Medicare Spends Nearly as Much on Breast Cancer Screenings as Treatments, Study Finds

January 10, 2013 — Medicare spends about $1.08 billion annually on breast cancer screenings, almost as much as the $1.36 billion it spends to treat the disease, according to a study published on Monday in JAMA Internal Medicine, Reuters reports (Seaman, Reuters, 1/8).

For the study, researchers at Yale University examined Medicare claims filed in 2006 and 2007 for mammograms and treatment for 137,274 women ages 66 through 100 who did not have breast cancer (Ostrow, Bloomberg News/Bangor Daily News, 1/8).

The study showed about $410 million of $1.08 billion was spent on screenings for women older than age 75. The U.S. Preventive Services Task Force has recommended against breast cancer screenings for women in that age group, citing a lack of evidence showing that they would benefit. Some medical organizations disagree with USPSTF. For example, the American Cancer Society recommends annual screenings for all women ages 40 and older (Lupkin, ABC News, 1/8).

Regional Variations

The researchers also found the price of breast cancer screening varied significantly by region, ranging from $42 to $107 per patient, Reuters reports (Reuters, 1/8).

They said the variations were related to the use of new, costlier screening methods that ultimately did not increase the detection of advanced cancer or show a corresponding reduction in treatment costs. Women in higher-spending areas were more often diagnosed with early breast cancer, which could lead to unnecessary treatment, according to study leader Cary Gross.

Commentary

In a commentary accompanying the study, Jeanne Mandelblatt -- associate director for Population Sciences at Lombardi Comprehensive Cancer Center -- argued that there is no evidence suggesting that new, higher-cost screening technologies benefit older women.

She writes that newer screening equipment is designed to improve examinations for dense breasts, which are more commonly found in younger women who have not reached menopause (Bloomberg News/Bangor Daily News, 1/8).

More Research Needed

Gross said the study did not determine whether mammograms are effective, but the results should prompt further research (ABC News, 1/8).

He added, "The fact that we are facing such severe budget constraints as a nation and the fact that Medicare is such a major expense in the federal budget, our findings really reinforce the imperative to clarify how we're spending our scarce Medicare dollars on cancer screening and to make sure we're using them effectively" (Bloomberg News/Bangor Daily News, 1/8).