Implementation of current Louisiana mammography legislation: a time for review

Breast cancer mortality rates in the state of Louisiana are higher than national averages despite a lower than average incidence rate. Given the importance of early diagnosis in determining breast cancer outcomes, one potential explanation for relatively high mortality rates is an under-utilization of effective techniques for early detection. Comparison of mammography rates in Medicare recipients indicates that Louisiana mammography rates are among the lowest in the nation. To better assess barriers to mammography utilization, all certified mammography sites in Louisiana were contacted by telephone by a surveyor posing as a family member attempting to schedule a mammogram for a 50-year-old woman. Of the 151 sites in Louisiana, successful scheduling of a mammogram by phone was accomplished nine times. The vast majority of sites (94%) did not schedule a mammogram. Furthermore, 75.9% of the sites contacted provided no assistance to the consumer seeking a mammogram. Current Louisiana law requires that mammography be ordered by a licensed health care provider. Though compliance with current law is high, this law may provide a barrier to interested consumers attempting to schedule mammography. A revision of current law and policy may be indicated in an effort to increase mammography utilization rates. Such an effort may potentially help to decrease mortality from the second leading cause of cancer death in women.