Are mammograms for older patients worth the cost?

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It seems that the controversy about the efficacy of screening for breast cancer is destined to continue.

A recent study published in the journal JAMA Internal Medicine shows that the Medicare program is spending a lot of money on screening--over $1 billion annually, to be more precise. The screening accounts for over 45 percent of the $2.42 billion total spent by Medicare on screening and the initial treatment phase of breast cancer.

This suggested, according to Cary Gross, M.D., of Yale University Medical School, and his colleagues, "that analyses that focus exclusively on treatment have overlooked a significant contributor to cancer costs."

In addition, the researchers said, regions of the country that spend the most to screen women older than 65 are more likely to use new and expensive screening technologies like digital mammography, but do not report better outcomes.

"Our study is largely directed at policymakers," Gross told HealthDay News. He added that getting more expensive tests for older women for breast cancer  "does not necessarily produce a better outcome."

Gross and his colleagues questioned Medicare's reimbursement strategy, which, they said supports the use of new modalities without any evidence they actually produce outcomes.

"Our study highlights the insanity of a system that pays substantially more for a new technology without any evidence that it is beneficial in the older population," Gross said.

Clearly questions need to be asked and answered--not only about the costs associated with screening older women, but also the benefits that result from those expenditures. - Mike  @FierceHealthIT