Recent trends in mammography utilization in the Medicare population: is there a cause for concern?

Recent published reports have shown a decline in the mammography screening rate in women over age 40, but it is not known whether this trend is a reason for concern in the Medicare population.

To study recent trends in mammography utilization in the Medicare population and determine how the newer digital mammography may be affecting mammography utilization.

The Centers for Medicare & Medicaid Services Physician/Supplier Procedure Summary Master Files for 1996 through 2005 were examined to determine overall trends in mammography utilization, as well as trends in screening vs diagnostic and conventional screen-film vs newer digital examinations. Medicare Limited Datasets for 2002 to 2004 were used to determine 2-year mammography and multiple imaging rates in individual patients.

Mammography utilization.

Overall, the mammography utilization rate increased from 26,646 per 100,000 in 1996 to 39,363 per 100,000 in 2005, a 48% increase. The diagnostic mammography rate decreased by 39% (from 15,314 to 9,301), whereas the rate for screening mammography increased by 166% (from 11,332 to 30,062). Digital mammography increased from 2.2% of all mammography in 2002 to 10.4% in 2005. In both digital and film mammography, screening increased more rapidly than diagnostic mammography.

The utilization rate of all mammography showed a substantial 48% increase between 1996 and 2005, and an 11% increase in screening mammography was seen between 2000 and 2005. Although the increase in mammography utilization is encouraging, the 2005 rate of 39,363 per 100,000 female Medicare beneficiaries seems to be well below American Cancer Society recommendations.